Age: 57
Sex: Female
Indication: Bilateral vision loss
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Case #18
Findings
- Confluent areas of white matter hypoattenuation in the bilateral parieto-occipital regions with associated mild sulcal effacement
- Lesser degree of white matter hypoattenuation in the high left frontal white matter
- Intermixed small intraparenchymal hematomas bilaterally with additional linear hyperdensities which may represent cortical hemorrhage or small volume subarachnoid hemorrhage
- Remote appearing left caudate head lacunar infarct
- Mucosal thickening of the paranasal sinuses with most extensive involvement of the right maxillary sinus and anterior right ethmoid air cells
Diagnosis
- Posterior reversible encephalopathy syndrome (PRES)
Sample Report
White matter edema involving the bilateral parieto-occipital regions and to a lesser extent the high left frontal lobe. This appearance and distribution is most suggestive of posterior reversible encephalopathy syndrome (PRES). Associated small intraparenchymal hematomas in the parieto-occipital regions as well as possible small volume subarachnoid hemorrhage and resultant sulcal effacement. No midline shift or evidence of herniation. Brain MRI could further assess for associated ischemia.
Remote appearing left caudate head lacunar infarct.
Paranasal sinus disease with most severe involvement of the right maxillary sinus and anterior right ethmoid air cells, which can be seen with acute sinusitis.
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