Pancreatic cancer with fever, altered mental status, hallucinations. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is minimal cerebral white matter T2 hyperintensity and a punctate focus of high T2 signal in the left thalamus. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The skull, orbits, and scalp soft tissues are unremarkable. There is a retention cyst in the left maxillary sinus.
1. No evidence of intracranial metastases.2. Minimal cerebral white matter T2 hyperintensity and a punctate focus of high T2 signal in the left thalamus may represent chronic small vessel ischemic disease and lacunar infarct, respectively, without evidence of acute infarction.