H/o lung cancer. Evaluate for brain metastasis. The previously described left occipital cortical nodule (image# 18-19 of series# 3151) is considered occipital gyrus. The current infused exam shows a 4-mm nodule left adjacent to the posterior sagittal sinus in the left occipital lobe, which corresponds to the lesion identified on the initial MRI dated 12/4/08. The surrounding edema/encephalomalacia is seen. No additional lesion is identified. The small vessel ischemic disease and right parietal encephalomalacia are again identified. No intracranial hemorrhage, mass effect, midline shift or abnormal extraaxial fluid collection is identified. The ventricles are normal in volume. The calvarium is intact.
Essentially stable head CT with a left occipital metastatic lesion. Small vessel ischemic disease of indeterminate age. 