Neuro_MR_Brain: 58 F, episodes of delirium and electrolyte abnormalities.

MRI BRAIN WITHOUT CONTRAST:

 

CLINICAL HISTORY: 58-year-old female, altered mental status, episodes of delirium and electrolyte abnormalities.

 

FINDINGS:

 

Parenchyma: No acute hemorrhage, infarction, or mass. Central pontine signal abnormality which crosses midline and follows CSF on all sequences without diffusion restriction or FLAIR hyperintensity. Other nonspecific FLAIR hyperintensities are also seen in the left pons and left frontal subcortical white matter. Old right thalamic lacune.

 

Ventricles and extra-axial spaces: Mild volume loss of the cerebellum is noted, which could be due to alcoholic or other metabolic degeneration. Ventricles are within normal limits for age.

 

Orbits: Normal.

 

Visualized paranasal sinuses: Clear.

 

Mastoid air cells: Clear.

 

Bones: Normal.

 

Additional comment: ASL demonstrates symmetric cerebral blood flow pattern.

 

Single sagittal T2 sequence of the cervical spine was obtained, which is nondiagnostic due to motion.

  

IMPRESSION:

 

1.  Central pontine signal abnormality which follows CSF on all sequences, without diffusion restriction or FLAIR hyperintensity. Favor remote osmotic demyelination syndrome; please correlate clinically.

 

2.  Mild volume loss of the cerebellum is seen, which could be due to alcoholic or other metabolic degeneration.

 

3.  No acute intracranial hemorrhage, acute infarct, or mass.