Demographics:
50 years old, Male
Indication:
Short-term memory loss
Findings
- Central T2/FLAIR signal hyperintensity in the pons with a rim of restricted diffusion and peripheral sparing
- Areas of faint T2/FLAIR signal hyperintensity in the periaqueductal gray matter, medial thalami, and hypothalamus
- No evidence of acute hemorrhage, mass effect, or hydrocephalus
- Mild mucosal thickening of the paranasal sinuses without fluid levels
- Displaced right mandibular condylar fracture (best seen on the postcontrast axial series)
Diagnosis
Osmotic demyelination
Possible Wernicke encephalopathy
Sample Report
Central T2/FLAIR signal hyperintensity in the pons concerning for osmotic demyelination syndrome. Recommend correlation with serum sodium measurements.
Areas of faint T2/FLAIR signal hyperintensity in the periaqueductal gray matter, medial thalami, and hypothalamus, which can be seen with Wernicke encephalopathy.
No evidence of acute hemorrhage, mass effect, or hydrocephalus.
Displaced right mandibular condylar fracture. Consider dedicated face CT for further assessment if not previously evaluated.
Discussion
References