Nontraumatic intracerebral hemorrhage in cerebellum [I61.4], Reason for Study: ^Reason: rule out intracranial mets given known endometrial ca History: pls see above Brain MRIThere are multifocal restricted diffusion lesions on bilateral hemispheres (right worse than left) as well as left caudate nucleus posterior body with some susceptibility artifacts on the right occipital lobe and right inferior parietal lobule lesion indicating focal hemorrhagic conversions.Previously seen right cerebellar hemispheric and vermian ICH with surrounding edema are re-demonstrated.On contrast enhanced scan, there are multiple nodular enhancements especially on the left frontal lobe just around the left pre central gyrus, bilateral occipital lobes and lateral aspect of the right cerebellar hematoma and left cerebellar hemisphere. These lesions could represent metastatic nodules. The ventricles, sulci and cisterns are symmetric and unremarkable. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.Brain MRA3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate normal ICAs, MCAs and ACAs. Vertebrobasilar system appears to be normal. No evidence of intracranial arterial aneurysm. No evidence of intracranial arterial luminal stenosis.
1. Multifocal acute ischemic infarctions with focal hemorrhagic conversions as described above.2. Multiple both supra and infra tentorial enhancing lesions suggest possible metastatic lesions as described above. 3. Unchanged right cerebellar and vermian hematoma with surrounding edema.4. Normal brain MRA.