Hypertensive Encephalopathy ( Posterior Reversible Encephalopathy Syndrome),Post Partum Cerebral Angiopathy.

You can observe here that the terminal arteries of both middle cerebral arteries are attenuated in addition to irregular pattern of basilar artery and right vertebral one; suggestive of post partum cerebral angiopathy

Clinical Indication: A history of eclampsia and ICU admission.

Imaging Technique:
The following  pulse sequences for the brain  were obtained  on a high field MRI.
Axial T1 and T2 weighted images
Coronal FLAIR images
Sagittal T2 weighted images
Axial FLAIR images of the brain parenchyma. 
Observations
    * Extra axial spaces: Normal in size and morphology
    * Hemorrhage: none    
    * Ventricular system: Normal in size and morphology
    * Basal cisterns: normal
    * Cerebral parenchyma: There are bilateral areas of subcortical white matter signal changes in the bilateral frontal, occipital as well as temporal lobes. These are involving the subcortical white matter as well as the cortex and seen as bright signal on the T2 and FLAIR images and iso to hypointense to the grey matter on the T1 weighted images. There are no areas of hemorrhage. 
    * Midline shift: none
    * Cerebellum: normal
    * Brainstem: normal

Other:
    * Calvarium: normal
    * Vascular system: normal
    * Visualized Paranasal sinuses: clear
    * Visualized Orbits: normal
    * Visualized upper cervical spine: normal
    * Sella and skull base: normal
    * Left/right mastoid air cells: Bilateral areas of mastoiditis. 
Impression:

• The features are highly suggestive of a hypertensive encephalopathy ( Posterior Reversible encephalopathy syndrome) in view of the history of eclampsia.  
• Post partum cerebral angiopathy.
• Incidental pansinusitis and mastoiditis. 

Reported By : DR.MOHAMED MOHY ELDIN
 HOD & Consultant-Radiologist
Report Status : Validated / Validated By :  Dr.MOHAMED MOHY ELDIN