73-year-old female with acute mental status changes evaluate for metastases. Again seen are multiple areas of hypoattenuation in the bilateral cerebellar hemispheres, basal ganglia, and the bilateral parietal lobes consistent with metastatic disease. No new definite metastatic lesions are seen. If there is clinical concern for a new metastatic lesion, contrast enhanced CT or MRI recommended.There are multiple areas of periventricular and subcortical hypoattenuation consistent with small vessel ischemic disease of indeterminate age. There is redemonstration of the low density focus in the brainstem which likely represents a chronic infarction.Hyperdense material in the left globe is evident, compatible with patient's known intra-ocular metastasis with possible hemorrhage.There is no evidence of intra-or extra axial hemorrhage, mass effect, or midline shift. The size of the ventricles remains stable. The visualized mastoid air cells and paranasal sinuses are clear.
1.No significant interval change in multiple intracranial metastatic lesions. If there is clinical concern for a new metastatic lesion, contrast enhanced CT or MRI is recommended.2. Stable hyperdense material in left globe, compatible with patient's known intra-ocular metastasis with possible hemorrhage. 