62 years Male (DOB:7/30/1953)Reason: Hx of head and neck cancer with AMS r/o mets / infarct History: altered mental statusPROVIDER/ATTENDING NAME: ANUBHA GANJOO KWANG JIN CHOI The exam is degraded by patient motion.The flow void of the left internal carotid artery is absent along the petrous and cavernous segments.There are punctate foci of T2 and FLAIR signal hyperintensity in the watershed zone in the periventricular white matter of the left hemisphere.There are punctate foci of T2 and FLAIR signal hyperintensity in the left pons and left midbrain associated volume loss. There are foci of T2 hyperintensity in the basal ganglia which are low signal on FLAIR MRI are present in enlarged perivascular spaces possibly related to prior vascular insults. A small focus of encephalomalacia is present along the inferior aspect of the right cerebellar hemisphere.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 demonstrate some mucosal thickening. The visualized portions of the mastoid air cells demonstrate opacities. The visualized portions of the orbits are intact.
1.There is occlusion of the left internal carotid artery associated with old watershed spinal foci of infarction in the left periventricular white matter and centrum semiovale.2.Punctate lesions involving the left brainstem and basal ganglia are suspected to be vascular related possibly to old lacunar infarcts.3.Small focus of encephalomalacia is present in the right cerebellar hemisphere. This is probably vascular related.4.Exam is degraded by patient motion. This may obscure smaller lesions. To the extent of visualization there is no evidence for brain metastases on the current exam.