 There is an ill-defined focus of signal abnormality involving the right temporooccipital junction demonstrating gyral thickening, gyral and sulcal enhancement, with associated vasogenic edema and mild mass effect upon the adjacent right lateral ventricle. It does not demonstrate restricted diffusion and has no susceptibility abnormality.Elsewhere there are foci of T2 hyperintensity within the white matter without associated mass effect, restricted diffusion, or enhancement representing chronic small vessel ischemic disease.A single punctate focus of susceptibility hypointensity is noted within the right paramedian pons, without other signal abnormality, most likely representing a remote microhemorrhage.The ventricles and sulci are unremarkable for age. The cerebellar tonsils are in normal position. The pituitary gland is normal in size. There is no evidence for intracranial hemorrhage or acute cerebral, brainstem or cerebellar infarction. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. The paranasal sinuses and mastoid air cells are clear.
There is an ill-defined focus of signal abnormality involving the right temporooccipital junction demonstrating gyral thickening, gyral and sulcal enhancement, with associated vasogenic edema and mild mass effect upon the adjacent right lateral ventricle. It does not demonstrate restricted diffusion and has no susceptibility abnormality. This appearance is most suggestive of involvement by lymphoma or less likely metastasis from other primary cancer. However, a portion of the described enhancement pattern can also be seen in the setting of seizure activity, which may be superimposed. This does not have the imaging appearance of a contusion.