Multiple myeloma, without mention of having achieved remission(203.00) [203.00] / Facial weakness [781.94], Reason for Study: ^Reason: eval for brain involvement of myeloma v. Stroke History: right facial weakness There is no evidence of acute ischemic or hemorrhagic lesion on the scan.Extensive involvement of normal bone marrow replacing lesions on skull, skull base including clivus and imaging cervical spine. The lesions show mixed signal intensity on T1 and T2 weighted images and show gadolinium enhancement. Among them, the largest lesion is about 40.8mm x 15.4mm sized slightly expansile soft tissue mass on the right posterior temporal area skull,Underlying brain shows patchy high signal intensity lesions on bilateral periventricular white matter and centrum semiovale indicate non specific small vessel ischemic disease.The ventricles are slightly prominent likely due to associated mild brain atrophy. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.
1. Extensive skull, skull base including clivus and cervical spine involvement of multiple myeloma as described above.2. No evidence of acute ischemic or hemorrhagic lesion.