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Widespread confluent bilateral areas of T2/FLAIR hyperintensities seen in the cortical, subcortical and deep white matter not conforming to any arterial territory. These areas show no evidence of restricted diffusion on DWI/ADC, isointense signal to white matter on T1W without enhancement on T1+C. No evidence of hemorrhage on GRE.
Based on presenting symptoms and demographics, an assessment of Mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS) was made.