Stage III C melanoma status post re-do right radical axillary lymph node dissection with excision of separate subcutaneous nodule of the right proximal upper extremity on 10/26/15 for metastatic melanoma, rule out brain metastasis. There is no evidence of intracranial mass, hemorrhage or acute infarct. There is no abnormal intracranial enhancement. There is patchy and confluent and intracerebral white matter T2 hyperintensity which may be nonspecific, but most compatible with small vessel ischemic changes. There is mild global parenchymal loss. There is no midline shift or herniation. The major cerebral flow voids are intact. There is mild mucosal thickening in the bilateral maxillary sinuses. There is trace fluid in the bilateral mastoid air cells. The orbits, skull and scalp soft tissues are grossly unremarkable.
1. No evidence of intracranial metastasis.2. Chronic small vessel ischemic changes, but no evidence of acute infarction.