63-year-old male with history of metastatic non-small cell lung cancer to the brain status post whole brain radiation therapy, now reporting new right eye floater, evaluate. There is no evidence of intracranial mass or abnormal enhancement to suggest metastatic disease. No evidence of hemorrhage or infarct. Again noted is diffuse confluent T2 hyperintensity in the subcortical and periventricular cerebral white matter, similar to the prior exam and likely reflecting treatment changes. There is unchanged nonspecific enhancement along the frontal horns, possibly vascular in etiology. There is diffuse mild ventricular and sulci enlargement, suggestive of parenchymal volume loss. No hydrocephalus. There is no midline shift or herniation. The major cerebral flow voids are intact. Bilateral orbits are grossly unremarkable. Calvarium and extracranial soft tissues are also grossly unremarkable.
1.No intracranial mass or abnormal enhancement to suggest metastatic disease.2.Extensive cerebral white matter signal abnormality, similar to prior exam and compatible with posttreatment changes.