60 years Female (DOB:4/4/1956)Reason: newly diagnosed lung cancer, eval for brain mets History: double vision, recent auto accident for unclear reasonPROVIDER/ATTENDING NAME: PHILIP C. HOFFMAN PHILIP C. HOFFMAN The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Periventricular punctate additional T2 and FLAIR hyperintense foci are present in the brainstem and external capsules.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 are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.Periventricular and subcortical white matter punctate lesions as well as some brainstem and external capsule punctate lesions of a mild degree are nonspecific. At this age they are most likely vascular related. 2.There is no evidence for brain metastases.