History of pancreatic cancer, depression with flat affect. Evaluate for metastatic disease. No intracranial mass or mass-effect. No abnormal parenchymal or meningeal enhancement. No restricted diffusion to suggest acute ischemia. No intracranial hemorrhage. The ventricles are within normal limits in size and configuration. There is evidence of prior small left cerebellar infarct. Several foci of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with mild chronic small vessel ischemic changes. Brain parenchyma is otherwise unremarkable for age. Major flow-voids are preserved.Sella and orbits are grossly within normal limits. Paranasal sinuses and mastoid cells are clear. Bone marrow signal and extracranial soft tissues are within normal limits.
1. No evidence of intracranial metastatic disease.2. Minimal global parenchymal volume loss, which appears within normal limits for age.3. Small chronic left cerebellar infarct. 4. Mild chronic small vessel ischemic changes. 