Lung cancer and brain metastasis treated via SRS. There is an unchanged punctate focus of susceptibility effect in the left cerebellar hemisphere, which corresponds to the treated metastatic lesions. Punctate foci of susceptibility in the right thalamus and right putamen are also unchanged and may represent chronic microhemorrhage. There is unchanged moderate periventricular and subcortical white matter punctate T2 hyperintense foci, compatible with chronic small vessel ischemic disease. There is no evidence of acute intracranial hemorrhage, new mass, or acute infarct. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, and scalp soft tissues are grossly unchanged. There is a punctate right maxillary sinus retention cyst.
A punctate treated lesion in the left cerebellar hemisphere and nonspecific scattered cerebral white matter disease are unchanged. Assessment for metastatic disease is otherwise limited due to the lack of intravenous contrast.