59-year-old female patient with status epilepticus, unresponsive. Evaluate for cause of seizure and possible left thalamic infarct.. There is a questionable focus of ischemia in the right anterior and lateral cerebellum given mild diffusion restriction and questionable FLAIR signal abnormality in this region. There is extensive patchy subcortical, periventricular, basal ganglia, and pontine T2 signal abnormality consistent with chronic small vessel ischemic disease. There is encephalomalacia within the right occipital lobe consistent with a chronic ischemic infarct. There are scattered foci of susceptibility artifact within the cerebral hemispheres and cerebellum which likely represents chronic blood products.There is a heterogeneously enhancing 1.1 x 1.1 cm extra-axial lesion along the right frontal convexity underlying the right frontal bone, which does not exert significant mass effect on the adjacent frontal lobe. No other abnormal parenchymal enhancement is seen . The ventricles are minimally prominent in size due to mild generalized parenchymal volume loss. There is no midline shift or herniation. The major cerebral flow voids are intact. There is a small air-fluid level in the left maxillary sinus and scattered paranasal sinus mucosal thickening. There are secretions within the posterior nasopharynx.
1. Questionable acute ischemic infarct in the right anterolateral cerebellum.2. Extensive chronic small vessel ischemic disease and chronic right occipital ischemic infarct.3. A right frontal convexity extra-axial lesion is favored to represent a meningioma. 