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Case #20

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Demographics: 53 years old, Female
Indication: Altered mental status

Findings

  • Small areas of FLAIR signal hyperintensity and restricted diffusion within bilateral frontoparietal sulci
  • 13 mm T2/FLAIR hyperintense structure associated with the pineal gland, which abuts and mildly deforms the superior colliculus
  • No evidence of acute infarct, hemorrhage, mass effect, or hydrocephalus

Diagnosis

Subtle meningitis

Sample Report

Small areas of FLAIR signal hyperintensity and restricted diffusion within bilateral frontoparietal sulci, which raise concern for proteinaceous debris/exudate in the setting of meningitis. No evidence of cerebritis or abscess.

No evidence of acute infarct, hemorrhage, mass effect, or hydrocephalus.

Incidental 13 mm pineal cyst. Recommend follow-up MRI in 12 months to confirm this diagnosis.

Discussion

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