65 years, Male, right face, arm and leg numbness. Evaluate for metastasis.. No restricted diffusion to suggest acute ischemia. No intracranial hemorrhage. No intracranial mass or mass-effect. The ventricles are within normal limits in size and configuration. Several foci and more confluent areas of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with mild to moderate chronic small vessel ischemic disease. There is a chronic lacunar infarct involving the left thalamus which was present on prior CT from 2015. Brain parenchyma is otherwise unremarkable for age.No abnormal parenchymal or meningeal enhancement. Major flow-voids are preserved.Sella and orbits are grossly within normal limits with evidence of right lens implant. There is moderate opacification throughout the paranasal sinuses. Mastoid air cells are clear. Bone marrow signal and extracranial soft tissues are grossly within normal limits.
1. No evidence of intracranial metastatic disease.2. Mild to moderate chronic small vessel ischemic disease with a chronic left thalamic lacunar infarct which was present on prior CT. No evidence of acute ischemia.3. Moderate opacification throughout the paranasal sinuses.