Neuro_MR_Brain: 21 M, history of liver transplant, AMS.

MRI BRAIN WITHOUT CONTRAST:

CLINICAL HISTORY: 21 years of age, Male, s/p liver transplant with mental status changes.

 

FINDINGS:

Abnormal patchy T2 hyperintensity and T1 hypointensity is noted in the bilateral central pons with minimal extension into the midbrain. On DWI there is subtle corresponding hyperintensity, although without clear decrease in signal on ADC map.  Small focus of abnormal T2 intensity is seen within the deep white matter of the right frontal lobe, which is non-specific. No abnormal basal ganglia signal.

Nonspecific abnormal T2 hyperintensity in the right mandibular head (9/28). The ventricles are preserved in size and configuration. There is no mass, hemorrhage, or acute infarction. No abnormal extracerebral collections are present. Symmetric perfusion on ASL.

IMPRESSION:

1.  Pontine findings as above described, may be seen with osmotic myelinolysis.

2.  Non-specific foci of T2/FLAIR signal abnormality in the right frontal white matter.

(Central pontine myelinolysis)