67-year-old female with episode of staring and confusion, stroke and seizure evaluation. Soft tissue swelling with mild enhancement is noted involving the soft tissues overlying the right forehead. There is no underlying osseous involvement. There is no restricted diffusion to suggest acute ischemia. No acute intracranial hemorrhage. No intracranial mass or mass-effect. No hydrocephalus. There is generalized global parenchymal volume loss, unchanged in extent. Multiple foci of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with mild chronic small vessel ischemic disease. T2 hyperintensity is noted within the bilateral subinsular white matter which is favored to be related to combination of chronic ischemic change and prominent perivascular spaces. Redemonstrated are few punctate foci of susceptibility effect in the bilateral temporal and occipital lobes compatible with chronic microhemorrhages. No abnormal parenchymal or meningeal enhancement. Major flow-voids are preserved. Sella and orbits are grossly within normal limits. Paranasal sinuses and mastoid cells are clear.
1.Soft tissue swelling with mild enhancement is noted involving the soft tissues overlying the right forehead. There is no underlying osseous involvement. This is nonspecific and may be secondary to injury, infection, inflammation, and unlikely neoplastic.2.Chronic small vessel ischemic disease.