Patient with lung mass. Evaluate for brain metastases. The ventricles and sulci are prominent, consistent with age-related volume loss. There is no pathological enhancement, midline shift or mass effect. There is no acute intracranial hemorrhage. There are scattered punctate foci and confluent areas of abnormal T2/FLAIR hyperintensity within the periventricular and subcortical white matter and pons, consistent with moderate chronic small vessel ischemic changes. There is an area of encephalomalacia in the left superior frontal gyrus, likely from chronic infarct. There are multiple scattered foci of susceptibility artifact within the supratentorial compartment, consistent with hemosiderin deposition. There is no extraaxial fluid collection. There are small mucous retention cysts within the bilateral maxillary sinuses. There is partial opacification of the right ethmoid air cells. The remaining visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear. There is pannus surrounding the odontoid process.
1. No abnormal parenchymal enhancement to suggest intracranial metastases. 2. Moderate chronic small vessel ischemic changes. 