Other symptoms and signs involving the musculoskeletal system [R29.898], Reason for Study: ^Reason: hx of metastatic melanoma, eval for mets to brain History: R shoulder twitching There is no evidence of acute ischemic lesion.Multiple susceptibility lesions on bilateral basal ganglia as well as a focal nodular susceptibility lesion on the right inferior parietal lobule are again seen without showing evidence of enhancement or surrounding edema.Curvilinear high signal intensity cortical lesions on the right inferior frontal gyrus , right parietal operculum and the left precentral gyrus are again seen without evidence of contrast enhancement, unchanged.There is no evidence of abnormal enhancement since prior scan.Scattered somewhat patchy bilateral periventricular white matter and centrum semiovale T2/FLAIR high signal intensity lesions indicating non specific small vessel ischemic lesions, unchanged.The ventricles, sulci and cisterns are unremarkable. There is no 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. No abnormal enhancement.2. Unchanged multifocal bilateral basal ganglia and the right inferior parietal lobule susceptibility lesions.3. Curvilinear bihemispheric non enhancing T1 high signal intensity lesions are seen, unchanged.4. Unchanged non specific small vessel ischemic disease. 