Renal mass and altered mental status. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is mild cerebral white matter T2 hyperintensity. There is diffuse cerebral volume loss. There is no midline shift or herniation. The major cerebral flow voids are intact. The skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable. There is a small defect in the left lamina papyracea, with protrusion of orbital fat. There is a right lens implant.
No evidence of intracranial metastases. Mild cerebral white matter T2 hyperintensity is nonspecific, but may represent chronic small vessel ischemic disease.