History of metastatic renal cell cancer, uncontrolled nausea/vomiting, evaluate for intracranial metastases No intracranial mass or abnormal parenchymal or meningeal enhancement is seen to suggest metastatic disease. No diffusion restriction is seen to suggest acute ischemia. Periventricular white matter T2/FLAIR hyperintense foci are compatible with mild small vessel ischemic disease, unchanged from the prior study. Additional T2/FLAIR hyperintense areas are seen in the right putamen/head of caudate and right post central gyrus are likely from prior infarction. No susceptibility weighted artifact is seen to suggest intracranial hemorrhage. A small lesion is seen in the right prepontine cistern which follows CSF signal and likely represents an arachnoid cyst, unchanged from the prior study. There is no significant mass effect from this lesion. The CSF spaces are appropriate for the patient's stated age with no midline shift. Normal vascular flow voids are present in the major intracranial vasculature. The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.Nonspecific enhancing scalp foci are seen in the left parietal and right frontal scalp. This may be secondary to prior inflammation/infection and are unchanged from the prior study. Given their stability, dermal metastases are considered unlikely.A subcentimeter right parotid nodule is present, likely representing a lymph node.
1. No evidence of intracranial metastatic disease.2. Chronic infarcts involving the right basal ganglia and right post central gyrus. Mild chronic small vessel ischemic disease.