History of right cheek melanoma, and headache with pontine mass seen on cervical spine MRI. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There are scattered punctate foci and confluent areas of abnormal T2/FLAIR hyperintensity within the periventricular and subcortical white matter and the pons, which are nonspecific, but most likely related to chronic microvascular disease. There is a non enhancing cystic focus in the pons as well as a smaller similar lesion in the left thalamus. There is a developmental venous anomaly in the right frontal lobe. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. Partially imaged is an enhancing lesion at the right C2-3 foramen on sagittal images. The skull and extracranial soft tissues are otherwise unremarkable.
1. Scattered T2 abnormalities in the periventricular and subcortical white matter and the pons, most likely representing chronic microvascular disease. Cystic focus in the pons as well as the left thalamus, which may represent cavitary foci related to ischemic lesions, less likely perivascular spaces, and very unlikely to be metastases. 2. No definite evidence of intracranial metastasis or acute intracranial abnormality.3. Partially imaged enhancing lesion at the right C2-3 foramen, as previously described.