Encephalopathy, known brain metastasis. Some of the sequences are degraded by patient motion. There is an enhancing lesion centered in the sphenoid triangle with epidural extension into the left middle cranial fossa that measures up to 5 mm in thickness, with mild mass effect upon the anterior pole of the temporal lobe and associated vasogenic edema. There is no evidence of intracranial hemorrhage or acute infarct. There is minimal periventricular white matter T2 hyperintensity, which is nonspecific. There is mild diffuse cerebral volume loss. There is mild coaptation of the right frontal horn of the lateral ventricle. There is no midline shift or herniation. The major cerebral flow voids are intact. There is mucosal thickening in the maxillary sinuses. There is a partially-imaged cystic lesion in deep lobe of the parotid gland that projects into the right parapharyngeal space that measures at least 15 mm. There are also multiple subcentimeter cystic foci in the superficial right parotid gland. There appear to be small scalp lipomas in the occipital region.
1. Unchanged metastatic lesion centered in the left sphenoid triangle with epidural extension into the left middle cranial fossa and associated mild vasogenic edema in the anterior temporal lobe.2. No evidence of acute intracranial hemorrhage or cerebral infarct.3. Multiple cystic lesions in the right parotid gland, which may be sequela of an inflammatory or autoimmune process versus a neoplastic condition such as Warthin tumors. Follow up with dedicated parotid imaging may be useful if clinically warranted.