History of breast cancer presents with altered mental status. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There are mild scattered areas of high T2 signal in the cerebral and pontine white matter. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits are grossly unremarkable. There are subcentimeter foci of enhancement in the right frontal and left parietal bones. The calvarium otherwise displays diffusely heterogeneous signal. There is partially-imaged tumor involving the C3 and C4 vertebrae with marked narrowing of the spinal canal. There are retained secretions in the right sphenoid sinus and mild mucosal thickening in the left maxillary sinus.
1. No evidence of intracranial hemorrhage, mass, or acute infarct. Mild scattered areas of high T2 signal in the cerebral and pontine white matter may represent chronic small vessel ischemic disease.2. Partially-imaged tumor involving the C3 and C4 vertebrae with marked narrowing of the spinal canal, which may have progressed since November 2015.3. Subcentimeter foci of enhancement in the right frontal and left parietal bones may represent venous lakes versus metastases. The calvarium otherwise appears heterogeneous diffusely, which is nonspecific.