45-year-old with leiomyosarcoma presenting with liver failure and decreasing mental status. Assess for cerebral edema. There is no evidence of intracranial hemorrhage or midline shift. A hyperintense focus near the terminus of the right internal carotid artery is worrisome for an aneurysm or metastasis (image 11/34, series 2). Given the patient's history of metastatic malignancy, an MRI/MRA with contrast is recommended for further evaluation and characterization. An additional questionable hyperintense focus is noted more posteriorly (image 22/34, series 2).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.
Hyperintense right cerebral lesion. An MRI/MRA with contrast is recommended for further evaluation.