Reason: Memory deterioration; evaluate for etiology. History of gastrointestinal stromal tumor. The CSF spaces are appropriate for the patient's stated age with no midline shift. There are punctate foci of signal loss present in the hippocampi, left thalamus, left and right cerebellar hemispheres, basal ganglia and the subcortical white matter.There is a moderate degree of periventricular and subcortical confluent hyperintense white matter lesions present identified on the FLAIR and T2 images. In addition, T2 and flair hyperintense lesions are present in the brain stem and internal capsules.No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells demonstrate some scattered opacities. The visualized portions of the orbits demonstrate a left ocular prosthesis .
1.Periventricular and subcortical white matter changes of a moderate degree are nonspecific. At this age they are most likely vascular related though they could be related to nonspecific leukoencephalopathy more be treatment related. Please correlate with the patient's clinical history.2.Lesions in the brainstem and internal capsules are also nonspecific but could be vascular related.3.There is a mild degree of microhemorrhages scattered along the cortex in both hemispheres as well as brainstem and basal ganglia. This is somewhat of a mixed pattern which can be seen with amyloid angiopathy or hypertension.4.There is no evidence for brain metastases.