History of breast cancer with progressive fatigue and lethargy for the past two months. Evaluate for central cause out fatigue and lethargy. There is no evidence of acute intracranial hemorrhage, acute infarct or enhancing intracranial mass. There are scattered T2 hyperintensities within the periventricular and subcortical white matter as well as the pons. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is scattered opacification of the bilateral mastoid air cells. There is fairly symmetric mild marrow enhancement of the bilateral parietal bones corresponding to osseous thickening on the prior CT without evidence of an aggressive or destructive process. The extracranial soft tissues are unremarkable.
1. No evidence of acute intracranial hemorrhage, acute infarct or enhancing intracranial mass.2. Nonspecific scattered T2 hyperintensities within the periventricular and subcortical white matter, which likely represent mild chronic small vessel ischemic changes.3. No obvious findings to account for the patient's symptoms.