Male, 73 years old, with altered mental status and encephalopathy. Evaluate for intracranial metastases. History of pancreatic cancer. Multiple scattered areas of gyriform restricted diffusion are seen within both cerebral hemispheres, predominantly in the MCA distributions. The most severely affected regions are the right posterior parietal and temporal lobes and the insula. Several scattered areas of restricted diffusion are also seen in the cerebellum.Corresponding T2 hyperintensity is seen with these areas of restricted diffusion with minimal local edema, but no significant generalized mass effect is seen. No masslike lesions or pathologic enhancement are seen. No evidence of intracranial hemorrhage or any abnormal extra axial fluid collection. The ventricles are normal in size and morphology.
Multiple scattered areas of restricted diffusion are noted in both cerebral hemispheres and on both sides of the cerebellum. An embolic phenomenon is favored. No evidence of intracranial metastases is seen.