Reason: recent MRI with new emboli, possible malignancy History: cognitive problems. 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.There are subcortical lesions are present within the brain parenchyma which are high signal on T2 and flair MRI and were also present on the prior exam and unchanged in distribution. These are distributed predominantly in the subcortical white matter of the superior frontal gyri and in true frontal gyri are also scattered in the temporal and parietal lobes elsewhere There are additional periventricular white matter lesions and signal hyperintensities are dumbly surrounding the temporal horns of lateral ventricles. Additional lesions are present along the external capsule and in the posterior limbs of internal capsules.The temporal horns of the lateral ventricles are large.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 are clear. The visualized portions of the orbits are intact. The eyeball lenses are thin.
1.No convincing evidence of brain metastasis.2.A mild degree of subcortical white matter lesions are present which are unchanged. These are non-specific and may relate to leukomalacia of unknown cause.3.Mild ventriculomegaly may be related to atrophy. Normal pressure hydrocephalus in the appropriate clinical setting may be an alternate consideration