Chronic meningoencephalitis, neoplasm, vasculitis. Persistent bilateral lower extremity weakness and encephalopathy of unclear etiology. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There are extensive areas of abnormal T2 hyperintensity within the periventricular and subcortical white matter, a few of which are increased in size or new, notably in the left temporal lobe and posterior limbs of the bilateral internal capsules. There are similar signal changes in bilateral basal ganglia and bilateral paramedian pons to a lesser degree. There is no abnormal parenchymal or leptomeningeal enhancement. There is an apparent prior right transfrontal surgical track with linear susceptibility effect. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. There is a nonspecific peripherally enhancing 6 mm nodule in the right temporal subcutaneous tissues, which is unchanged from 11/17/2014. There are multiple prominent occipital arachnoid granulations. There is a right posterior frontal burr hole. There is a mucous retention cyst in the right maxillary sinus.
1. No evidence of acute intracranial hemorrhage, mass, brain abscess, or acute cerebral infarct.2. Extensive areas of abnormal signal in the cerebral white matter are non-specific, but may represent chronic small vessel ischemic disease. 3. A nonspecific subcentimeter nodule in the right temporal subcutaneous tissues is unchanged.