New onset seizure and breast cancer, evaluate for leptomeningeal carcinomatosis. The post-contrast images are particularly degraded by patient motion. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There are extensive areas of patchy cerebral white matter T2 hyperintensity. There is a small area of encephalomalacia in the right cerebellar hemisphere. There is no abnormal intracranial enhancement. There is a partially-empty sella. 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, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
1. No evidence of gross leptomeningeal carcinomatosis or other forms of intracranial metastases, although the post-contrast images are degraded by patient motion. 2. Extensive areas of patchy cerebral white matter T2 hyperintensity may represent treatment effects and/or chronic microvascular ischemic disease otherwise. 3. Small chronic infarct in the right cerebellar hemisphere.