59-year-old female with metastatic esophageal cancer. Has esophageal stent and g-tube. Persistent nausea and vomiting with new headache/vision change. Please evaluate for central mets, leptomeningeal spread, or etiology of persistent nausea and vomiting. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There are scattered punctate foci of abnormal T2/FLAIR hyperintensity within the periventricular and subcortical white matter, consistent with minimal chronic small vessel ischemic changes. The brain parenchyma otherwise appears unremarkable. There is no abnormal parenchymal or leptomeningeal enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The skull and extracranial soft tissues are unremarkable.
1. No evidence of intracranial metastases or leptomeningeal enhancement.2. Minimal chronic small vessel ischemic changes. 