 There is no territorially restricted diffusion to suggest acute territorial ischemic infarction. There is an intra-axial lesion centered within the left superior parietal lobe which demonstrates a thin rim of peripheral enhancement and measures approximately 10 x 12 x 14 mm. This lesion demonstrates restricted diffusion centrally. There is a moderate amount of abnormally increased T2/FLAIR signal within the adjacent white matter in the left parietal lobe compatible with vasogenic edema. There is an additional focus of abnormal enhancement in the left precuneus parietal lobe just posterior to the splenium which measures 6 x 6 mm and also has a small amount of adjacent vasogenic edema. There is an additional abnormal enhancing lesion within the right temporal lobe within the posterior aspect of the inferior temporal gyrus which measures 6 x 9 mm with a moderate amount of surrounding vasogenic edema extending into the adjacent temporal lobe. Each of the lesions demonstrates subtle decreased signal on susceptibility weighted images compatible with small amount of microhemorrhage. There are additional punctate confluent foci of increased T2/FLAIR signal within the periventricular and subcortical white matter compatible with mild chronic small vessel ischemic changes. The ventricles are normal in size and configuration. Basal cisterns remain patent. The expected major intracranial vessel flow voids are present. The skull and extracranial soft tissues are grossly unremarkable.
1.Abnormal enhancing lesions within the supratentorial brain with associated surrounding vasogenic edema. Primary differential considerations include multiple metastases or abscesses.2.No acute territorial infarction. Mild chronic small vessel ischemic changes.