69-year-old female with metastatic pancreatic cancer and meningismus. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There are minimal nonspecific foci of high T2 signal in the cerebral white matter without abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There are a mild amount of scattered foci of hyperintense T2 to signal in the periventricular and subcortical white matter, likely related to chronic small vessel ischemic changes. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable. There is fluid signal within and enhancement surrounding a few of the left mastoid air cells. There are degenerative changes in the left temporomandibular joint.
1. No evidence of intracranial metastases. 2. Fluid signal and enhancement in the left mastoid air cells may represent mastoiditis.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.