62 years, Male, confusion. History of lung mass and recent embolization for hemoptysis. There is no intracranial mass or abnormal enhancement to suggest metastatic disease. No restricted diffusion to suggest acute ischemia. No intracranial hemorrhage. No evidence of intracranial mass effect, midline shift, or herniation. No hydrocephalus. No extra-axial collections.Multiple foci of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with moderate chronic small vessel ischemic disease. Small lacunar infarcts are suspected including the left thalamus and right external capsule. There is also mild global parenchymal volume loss. Major flow-voids are preserved.Sella and orbits are grossly within normal limits. There is mild mucosal thickening involving the ethmoid air cells and small left maxillary mucus retention cyst. Skin lesion is noted in the left malar region which can be correlated with direct examination. Calvarium and remainder of the extracranial soft tissues are grossly unremarkable.
1. No evidence of intracranial metastatic disease.2. Moderate chronic small vessel ischemic disease.3. Left malar skin lesion, which can be correlated with physical exam.