Newly diagnosed lung cancer for staging. Evaluation for metastases is limited by lack of intravenous contrast. There is no evidence of intracranial hemorrhage or acute infarct. There are scattered punctate foci of abnormal T2 hyperintensity within the periventricular and subcortical white matter and pons, which are non-specific. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is a 5 mm prominent flow void at the right middle cerebral artery bifurcation. The skull and extracranial soft tissues are unremarkable.
1. Evaluation for metastases is limited by lack of intravenous contrast. No intracranial mass or mass effect is seen to suggest intracranial metastatic disease.2. Scattered foci of abnormal signal within the periventricular and subcortical white matter and pons, which are non-specific, but most likely represent chronic small vessel ischemic disease.3. Approximately 5 mm prominent flow void at the right middle cerebral artery bifurcation, which may represent a small aneurysm. Consider MRA for further evaluation as clinically warranted. 