Loss of consciousness. Comparison is size. Patient has history of esophageal cancer. Please see seen punctate focus of enhancement involving the right post central gyrus is no longer appreciated. No abnormal parenchymal or meningeal enhancement is appreciated on the current study to suggest metastatic disease. No suspicious intracranial mass or evidence of mass effect. No evidence of acute ischemia or hemorrhage. There are multiple scattered foci of T2/FLAIR hyperintensity in the subcortical and periventricular white matter which are nonspecific but compatible with mild chronic small vessel ischemic changes.Again seen is a cystic lesion that measures approximately 10 x 8 mm in the anterior right temporal lobe and appears contiguous with the right sylvian cistern. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits are grossly unremarkable. There is a non-enhancing ovoid lesion in the left occipital scalp that measures up to 22 mm, which likely represents an inclusion cyst. There is an intrinsically T1 hyperintense lesion in the left parietal calvarium, which may represent a hemangioma.
1. Previously seen punctate focus of enhancement in the right postcentral gyrus is no longer appreciated. There is no abnormal enhancement or intracranial mass to suggest metastatic disease.2. Unchanged cystic lesion in the anterior right temporal lobe without enhancement which most likely represents a benign entity such as a neuroglial cyst.