Neuro_MR_Brain: 61 M, SAH.

MRI BRAIN WITH AND WITHOUT CONTRAST:

CLINICAL HISTORY: Follow-up recent MRI.

FINDINGS:

Parenchyma:

Persistent susceptibility artifact on GRE sequences overlying the sulci of the left cerebral hemisphere, similar compared to prior study, compatible with hemosiderin staining of the leptomeninges. Additional few left cerebral hemispheric parenchymal hemosiderin stains remain unchanged, possibly slightly improved. The left 

cortical and gray-white matter junction FLAIR signal abnormalities are slightly improving compared to prior study. There is no associated abnormal enhancement or mass. There is interval resolution of the previously markedly thickened left cerebral cortex. No infarction, mass, or abnormal enhancement. Again seen are markedly prominent bilateral Virchow-Robin spaces.

Ventricles and extra-axial spaces: Appropriate for age.

Orbits: Normal.

Visualized paranasal sinuses: Mucosal thickening of the bilateral maxillary sinuses is seen, which is improved compared to prior study.

Mastoid air cells: Clear.

Bones: Normal.

Additional comment: None.

IMPRESSION:

1. Persistent left hemispheric leptomeningeal and scattered intraparenchymal hemosiderin staining, but improved/resolved left hemispheric cortical swelling and hyperintensity. The etiology of the swelling remains uncertain, but it is possibly that leptomeningeal amyloidosis could explain subarachnoid hemorrhage that then could have triggered a seizure and brain swelling. Ongoing follow up may be helpful in assessing underlying causes for these findings. 

2. No acute infarction. No new lesions or findings.