word finding deficit, history of NSCLC. Multiple restricted diffusion lesions on bilateral hemispheres, right thalamus and right cerebellar hemisphere indicating acute ischemic infarctions. No evidence of hemorrhagic conversion.The left side of clivus shows relatively well marginated, subtle enhancing lesion (22mm x 17mm) about mainly low signal intensity on T1 and low signal intensity on T2 weighted images. Considering the patient's history of NSCLC and prior PET scan, this lesion is likely represent metastatic bony lesion. The ventricles, sulci and cisterns are symmetric and unremarkable.There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage,or abnormal contrast enhancement. The midline structures are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate normal flow enhancement in bilateral ICAs, bilateral MCAs and ACAs. Acom artery is patent and right Pcom artery is patent but the left Pcom is not seen. There is no intracranial aneurysm. There is no intracranial large vessel occlusion.3D MRA neck post-gadolinium images with maximum intensity projections of the cervical vasculature demonstrate normal flow enhancement in a normal aortic arch origin of the right brachiocephalic, left common carotid, and left subclavian arteries. The vertebral artery origins are normal. There is normal flow enhancement through the bilateral common carotid, carotid bifurcations, internal/external carotid, and vertebral arteries. 3D MRV brain post-gadolinium with maximum intensity projections of the superficial/deep intracranial venous drainage demonstrate normal flow enhancement in the superior sagittal sinus, transverse sinuses, sigmoid sinuses, internal cerebral veins, vein of Galen and straight sinus.
1. Multifocal acute ischemic infarctions on bilateral hemispheres, right thalamus and right cerebellar hemisphere without evidence of hemorrhagic conversion.2. 22mm x 17mm sized lesion on the left side of clivus likely represent metastatic lesion.3. No evidence of intracranial arterial aneurysm. No intracranial arterial stenosis.4. Normal extracranial craniocervical arterial system.5. Normal intracranial superficial and deep venous system on MRV.