Headaches and history of thyroid cancer. Evaluation for small intracranial metastatic lesions is limited by lack of intravenous contrast. There is no evidence of intracranial hemorrhage or acute infarct. There is a nodular 9 mm area of T2/FLAIR signal hyperintensity within the left superior frontal gyrus. An additional punctate foci within the left frontal subcortical white matter is noted. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is diffuse low T1 signal of the calvarium, which is nonspecific, but can be seen in the setting of chronic anemia. The extracranial soft tissues are unremarkable.
1. Evaluation for small intracranial metastases is limited by lack of intravenous contrast. A 9 mm area of T2/FLAIR signal hyperintensity within the left superior frontal gyrus has a nodular appearance and suspicious for metastatic disease. Additional punctate focus in the left frontal subcortical white matter is more nonspecific and may be related to prior inflammation or infection for example. If there are no contraindications, contrast enhanced MR is recommended for further evaluation.2. No evidence of intracranial hemorrhage or acute infarct.