Concern for progression of sarcoid intracranially: worsening headache. There are unchanged multifocal osseous lesions, including within the right parietal calvarium, occipital bone, central skull base, bilateral sphenoid greater wings, and right mandible condyle and neck. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There are a few scattered punctate foci of nonspecific T2 hyperintensity in the cerebral white matter bilaterally. There is no abnormal leptomeningeal or intraparenchymal enhancement. The pituitary gland appears to be unchanged. 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.
1. Unchanged stigmata of multifocal osseous sarcoidosis in the head and upper cervical spine.2. A few scattered punctate foci of T2 hyperintensity in the cerebral white matter bilaterally are nonspecific. Otherwise, no evidence of neurosarcoidosis involving the brain parenchyma. 