Invasive bladder cancer. Confusion, for 1 week. Rule out brain metastasis. Study is mildly limited by patient motion.There is no space-occupying or contrast-enhancing brain mass. However, there is a 3 mm focal T2-hyperintensity without contrast enhancement or diffusion restriction (only T2 shine through) involving the cortex in the right superior parietal lobule, which is best seen on image #176 of series #306. This is nonspecific and too small to definitively characterize. It may represent late subacute or even chronic tiny infarct. There is generalized mild-to-moderate brain volume loss manifested by expansion of the ventricles and other CSF-containing spaces. There is trace if any frontal periventricular white-matter T2-hyperintensity. There is no significant brain abnormality otherwise. Major intracranial basilar flow voids are preserved, affecting gross patency.There is trace mucosal thickening in the maxillary and anterior ethmoid sinuses. There is no gross orbital abnormality. There is no destructive skull lesion. Hyperostosis frontalis interna is a common finding of no clinical significance.
1.Study is limited by patient motion.2.Punctate T2-hyperintense cortically based lesion in the right parietal lobe without contrast enhancement or diffusion restriction is nonspecific and may represent late subacute or chronic tiny infarct. 3.There is no contrast-enhancing or space-occupying brain lesion to indicate metastasis.4.Mild-to-moderate brain volume loss.