Small cell lung cancer, restaging and consideration of prophylactic cranial radiation . There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is diffuse cerebral white matter T2 hyperintensity bilaterally. There are also small areas of encephalomalacia in the bilateral cerebellar hemispheres. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The right internal carotid artery aneurysm is better depicted on the prior MRA. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
1. No evidence of intracranial metastases.2. Chronic small vessel ischemic white matter disease and chronic bilateral cerebellar hemisphere lacunar infarcts.3. The right internal carotid artery aneurysm is better depicted on the prior MRA. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.