Haemorrhagic lesions in the bilateral parieto-occipital lobes with surrounding vasogenic oedema. Central susceptibility and peripheral restricted diffusion. Cortical restricted diffusion further demonstrated at the left posterior frontal lobe and left posterior insular cortex. Not all of these demonstrate associated susceptibility. Foci of subcortical restricted diffusion involving bilateral medial temporal lobes but greater on the left. Left temporo-parietal subarachnoid haemorrhage.
No significant stenosis or occlusion in the major vessels of the circle of Willis. Minor reduction in the calibre of the left middle cerebral artery and left cavernous segment of the internal carotid artery without evidence of definite beading. No intracranial aneurysm.
Conclusion: Bilateral haemorrhagic lesions with surrounding vasogenic oedema of the parieto-occipital lobes. Cortical restricted diffusion with minimal associated susceptibility favouring ischaemia or infarction. Appearance is compatible with PRES with parieto-occipital distribution.