Lung adenocarcinoma with new headache, on anticoagulation. There is no evidence of intracranial hemorrhage or acute infarct. There is a 9 x 7 mm enhancing focus in the right superior frontal gyrus cortex, with mild associated T2 hyperintensity, suggestive of a metastatic lesion. There are mild scattered foci of nonspecific cerebral white matter T2 hyperintensity without associated enhancement. There is no midline shift or herniation. The ventricles and basal cisterns are normal in size and configuration. The major cerebral flow voids are intact. An 8 x 7 mm enhancing focus in the left frontal calvarium is suggestive of osseous metastasis. The orbits and scalp soft tissues are grossly unremarkable. There is moderate bilateral maxillary sinus mucosal thickening with air-fluid levels, as well as mild scattered ethmoid opacification and sphenoid sinus mucosal thickening. The mastoids and middle ears are clear.
1.Subcentimeter lesions in the right frontal lobe and left frontal calvarium are suggestive of metastases.2.Findings suggestive of acute sinusitis.3.No evidence of intracranial hemorrhage or acute infarct.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.