82-year-old female with metastatic cancer. Rule out brain metastases prior to anticoagulation. There is no evidence of intracranial hemorrhage, edema, or midline shift. Patchy areas of subcortical and periventricular white matter hypodensity likely represent extensive small vessel ischemic disease, age indeterminate by CT. Calcifications are noted in the basal ganglia bilaterally. Two foci of dystrophic calcification are noted in the right cerebellar hemisphere with a surrounding area of focal low attenuation. Though this could represent microangiopathic changes with dystrophic calcification, a neoplastic lesion cannot be ruled out an MRI with intravenous contrast is recommended for further evaluation.The ventricles and basal cisterns are normal in size and configuration.The calvaria and skull base are radiographically normal. The visualized paranasal sinuses and mastoid air cells are normally pneumatized.These findings were communicated to the clinical service at the time of interpretation.
Extensive small vessel ischemic disease, age indeterminate. An area of low attenuation with foci of calcification in the right cerebellar hemisphere may represent microangiopathic changes, but a neoplastic lesion cannot be ruled out. MRI with intravenous contrast is recommended for further evaluation.