66 years Female (DOB:6/2/1949)Reason: evidence of mets? History: Has had AMS and was lethargic, MS has somewhat improved, however concern for mets. Has leukemia.PROVIDER/ATTENDING NAME: LUCY A GODLEY LUCY A GODLEY There is evolution of a right posterior temporal lobe hematoma. It is smaller on the current exam and is surrounded by vasogenic pattern of T2 signal hyperintensity.There is a moderate degree of periventricular and subcortical confluent hyperintense white matter lesions present identified on the FLAIR and T2 images.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.Continued evolution of right temporal lobe hemorrhage. There is no convincing evidence for metastatic disease at this time.2.Periventricular and subcortical white matter signal changes are nonspecific. At this age they are most likely vascular related though they could be related to a neurodegenerative process such as nonspecific leukoencephalopathy of aging. This could also be treatment related.