Clinical question: Hoarseness, visual changes and with history of breast cancer. Rule out intracranial disease/metastases. Signs and symptoms: Visual changes and hoarseness. Pre and post enhanced brain MRI:No acute intracranial process and negative diffusion weighted series.Examination demonstrates to tiny foci of FLAIR/T2 hyperintensity in the subcortical white matter of right frontal lobe without hemorrhagic changes or abnormal enhancement. Findings are nonspecific and of no clinical significance.The anatomical morphology and signal intensity of brain parenchyma is otherwise within normal on all MRI sequences. The cerebral cortex, cortical sulci, ventricular system, CSF spaces and brain myelination is unremarkable.Post enhanced images demonstrate no detectable abnormal enhancement of brain parenchyma or the leptomeninges to suggest metastatic disease.A tiny right frontal developmental venous anomaly is however detected at the level of right frontal horn of lateral ventricle of no clinical significance.Calvarium and soft tissues of the scalp as well as images through the orbits and including axial fat sat post enhanced series are unremarkable.All paranasal sinuses and bilateral mastoid air cells and middle ear cavities demonstrate normal pneumatization signal patterns.
Unremarkable pre and post enhanced brain MRI.