Evaluate for any intracranial lesions, mets, stroke, demyelinating lesions, also please particularly comment on any abnormalities in the pituitary gland: mesothelioma on pembrolizumab, presenting with altered mental status, word finding difficulty, hyperreflexia, possible central adrenal insufficiency. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is encephalomalacia in the left basal ganglia with susceptibility effect and ex vacuo dilatation of the frontal horn of the left lateral ventricle. There are also a few scattered foci of high T2 signal in the cerebral white matter bilaterally. There is no abnormal intracranial enhancement. The pituitary gland is grossly unremarkable. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
1. No evidence of intracranial hemorrhage, mass, or acute infarct. 2. Chronic left basal ganglia hemorrhagic infarct.3. A few scattered foci of high T2 signal in the cerebral white matter bilaterally are nonspecific. 4. The pituitary gland is grossly unremarkable.