67 years Female (DOB:8/14/1948)Reason: Mets small cell lung cancer, s/p 2 lines of therapy, now with disease progression, pls evaluate CNS status as restaging. History: mets small cell lung cancerPROVIDER/ATTENDING NAME: JYOTI D PATEL JYOTI D PATEL The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells demonstrate partial opacification of the left mastoid air cells. There appears to be some signal hyperintensity on FLAIR imaging within the left jugular vein and sigmoid sinus. The visualized portions of the orbits are intact.
1.There is no evidence for brain metastases.2.There is fluid in left mastoid air cells. The possibility of mastoiditis cannot be excluded. Some adjacent signal hyperintensity involving the left jugular vein and sigmoid sinus is nonspecific and of uncertain significance however, in theory to could potentially represent inflammatory reaction.