 There is no evidence of acute intracranial hemorrhage, mass, or acute infarct. There is unchanged extensive confluent T2 hyperintensity within the supratentorial white matter, as well as involving the basal ganglia, thalami, brainstem, and cerebellar white matter. There are multiple unchanged punctate foci of susceptibility effect in the supratentorial and infratentorial white matter. There is no definite abnormal intracranial enhancement. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The skull and scalp soft tissues are unremarkable. There is fluid within left mastoid air cells and minimal paranasal sinus mucosal thickening.
Unchanged treatment related effects including confluent T2 hyperintensity throughout the white matter and numerous punctate foci of susceptibility effect, which may represent treated metastases, microhemorrhages, and/or cavernous malformations. Assessment for metastatic disease is otherwise limited due to the lack of intravenous contrast. 