68-year-old man with history of laryngeal cancer, evaluate for metastases. There is no intracranial mass or mass-effect. There is a moderate degree of confluent T2 hyperintensity in the bilateral cerebral white matter and pons, along with chronic lacunar infarcts in the left corona radiata, right cerebellum, and right basal ganglia. There is no restricted diffusion to suggest acute ischemia. There are punctate foci of susceptibility effect in the right posterior temporal lobe, which may represent chronic microhemorrhages, but otherwise no evidence of acute intracranial hemorrhage. There is no abnormal parenchymal or meningeal enhancement. The ventricles are within normal limits in size and configuration. The major flow-voids are preserved. There is a small amount of secretions in the maxillary sinuses, right greater than left. Otherwise, the paranasal sinuses, orbits, skull, and overlying scalp are unremarkable.
1. No evidence of intracranial metastasis.2. Probable chronic small vessel ischemic disease in the cerebral white matter and pons, along with chronic lacunar infarcts in the left corona radiata, right cerebellum, and right basal ganglia. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.