Patient with history of metastatic lung cancer, presenting with right leg numbness, evaluate for metastatic disease. There is no evidence of intracranial hemorrhage, mass, or acute infarct. No mass effect or abnormal enhancement is identified to indicate intracranial metastatic disease. The ventricles and sulci are prominent likely reflecting global parenchymal volume loss. There are multiple areas of T2/FLAIR hyperintensity in the subcortical and periventricular deep white matter which are nonspecific but suggestive of moderate chronic microvascular ischemic disease, unchanged as compared to prior exam. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, and scalp soft tissues are grossly unremarkable. There is patchy opacification of the paranasal sinuses, relatively more prominent in the right maxillary sinus. No discrete destructive calvarial lesions are identified.
1.No mass or abnormal enhancement to suggest intracranial metastatic disease.2.Multiple areas of T2/FLAIR hyperintensity in the subcortical and periventricular deep white matter which are nonspecific but suggestive of chronic microvascular ischemic disease, unchanged as compared to prior exam.3.No evidence of acute intracranial hemorrhage or acute infarct.