68 years Male (DOB:10/5/1947)Reason: Hx of lymphoma, new ataxia, rule out CNS involvement History: see abovePROVIDER/ATTENDING NAME: CARA ANN ROSENBAUM CARA ANN ROSENBAUM There are subdural effusions present in the posterior fossa and supratentorial brain which were also present on the prior exam and have not changed substantially.There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images. Since the prior exam there've been a couple new periventricular white matter lesions. Specifically one in the left centrum semiovale is new. T2 hyperintense punctate lesion is also present in the subcortical white matter of the cerebellum at the level of the upper vermis. This was also present on the prior exam and is also unchanged.There are a few punctate T2 and FLAIR hyperintense foci present in the brainstem which were also present on the prior exam and do not appear to have changed significantly.There is a focus of encephalomalacia and susceptibility artifact which is redemonstrated along the medial aspect of the right occipital lobe. There is redemonstration of multiple punctate foci of signal loss and susceptibility imaging in the subcortical white matter of the supratentorial brain which were also present on the prior exam and have not changed significantly in number.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 demonstrate some mucosal thickening in the left maxillary sinus and an asymmetrically smaller left maxillary sinus relative to the right maxillary sinus. The visualized portions of the mastoid air cells demonstrate opacities in the left mastoid air cells.. The visualized portions of the orbits are intact.
1.Since the prior exam periventricular and subcortical white matter lesions have mildly increased in number.2.There are multiple microhemorrhages present in the subcortical white matter which are stable compared to prior exam. These are nonspecific. One possibility is that they're related to amyloid angiopathy.3.A focus of encephalomalacia and associated old blood products is redemonstrated in the right occipital lobe. This has not changed.4.Subdural effusions are likely related to atrophy.5.There is no evidence for a new enhancing lesion within the brain parenchyma to suggest CNS lymphoma.