Patchy bilateral but slightly asymmetric white matter T2/FLAIR hyperintensity are demonstrated in bilateral frontal lobes, parietal occipital lobes, cerebellar hemispheres, left corona radiata and in the left pons. There is a predominance in the parietal occipital lobes and the cerebellar hemispheres. There are some areas that demonstrate cortical involvement and gyral expansion. Multiple punctate foci of susceptibility artefact, in keeping with microhemorrhages, are demonstrated with a similar distribution, most prominent in the left frontal lobe. Punctate abnormal diffusion restriction, compatible with tiny infarcts, are seen in the right cerebellum, right parietal and bilateral frontal cortices. No definite subarachnoid haemorrhage. No abnormal enhancement. No hydrocephalus. No intracranial mass or collection. There is no convincing intracranial arterial irregularity on the time-of-flight MR angiogram allowing for artefact.
Conclusion: Findings are most in keeping with posterior reversible encephalopathy syndrome (PRES).