 No evidence of acute ischemic or hemorrhagic lesion.There are multifocal T1 high signal intensity lesions following the cortex involving left precentral gyrus right inferior frontal gyrus and right parietal operculum. These lesions do not show susceptibility artifacts nor evidence of enhancement.Constellation of above findings indicate possible laminar necrosis due to prior ischemic insult. The possibility of metastasis is unlikely.There is no evidence of abnormal enhancement on the scan.Focal susceptibility lesion is seen at right superior parietal lobule without associated surrounding edema. This is non specific and may indicate parenchymal chronic blood product or calcification. Multifocal scattered bihemispheric T2/FLAIR high signal intensity lesions involving bilateral periventricular white matter, centrum semiovale, bilateral basal ganglia and thalami are seen, unchanged.Left frontal and right posterior parietal non enhancing scalp lesion indicating inclusion cyst or pilar cyst are again seen, unchanged.The ventricles, sulci and cisterns are unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia, or abnormal contrast enhancement. About 2-3mm sized downward tonsilar displacement, unchanged.Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.Bilateral lens signals are not seen indicating post operative status.
1. No evidence of acute ischemic or hemorrhagic lesion.2. No evidence of abnormal enhancement.3. Multifocal cortical T1 high signal intensity lesions may indicate prior ischemic insult with cortical laminar necrosis.4. Extensive white matter FLAIR/T2 high signal intensity lesions may indicate non specific small vessel ischemic disease, unchanged since prior scan.