60 year old male with history of metastatic lung cancer, metastasis to bone, recent C2-C5 laminectomy, now with altered mental status. No evidence of acute ischemic or hemorrhagic lesion.There is no abnormal enhancement.There are multifocal scattered high signal intensities on bilateral periventricular white matter on FLAIR images indicating non specific small vessel ischemic disease.There are metallic artifacts on C2 level which corresponds the patient history of C2-C5 laminectomy.The ventricles, sulci and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia, or abnormal contrast enhancement. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses are clear.There are focal fluid collections on the left mastoid air cells.
No acute ischemic or hemorrhagic lesion on this scan.No abnormal enhancement.Mild non specific small vessel ischemic disease. 