Metastatic germ cell tumor: headache. There is an enhancing lesion in the occipital bone, which measures up to 10 mm. There is also an enhancing lesion in the right parietal bone There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma and pituitary gland appear unremarkable. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits are unremarkable. There are small bilateral maxillary and left frontal sinus retention cysts.
Small skull lesions likely represent metastases. Otherwise, no evidence of intracranial metastases. 