Fever, unspecified [R50.9], Reason for Study: ^Reason: 70 year old with orthotopic heart transplant, evaluate for brain parenchymal abnormalities History: elevated CSF protein There is no evidence of acute ischemic or hemorrhagic lesion on scan.Multifocal tissue losses indicating lacunar infarcts are seen on bilateral cerebellar hemispheres.Previously shown right occipital lobe FLAIR high signal intensity lesion is not as conspicuous on today's scan (series 5, image 14/35), thus may indicate evolving prior ischemic lesion. Multifocal bihemispheric susceptibility lesions are seen, unchanged in terms of size, distribution and numbers.Scattered FLAIR/T2 high signal intensity lesions on bilateral periventricular white matter are again seen, unchanged, indicating non specific small vessel disease.The ventricles, sulci and cisterns are unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia, or abnormal contrast enhancement. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.
1. No evidence of acute ischemic or hemorrhagic lesion.2. Unchanged multifocal susceptibility lesions.3. No evidence of abnormal enhancement.