61-year-old female with metastatic breast cancer and known brain metastases with new onset atrial fibrillation. Now with mental status change. Evaluate for acute CVA or hemorrhage. Multiple low attenuation areas correspond to vasogenic edema secondary to known metastatic foci are seen involving both cerebral hemispheres. Some of these lesions correspond to those on MRI from 3 months prior, however all cannot be appreciated on this exam. No definite new lesions identified. There is no evidence of intracranial hemorrhage. 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.
Multiple low attenuation areas correspond to vasogenic edema from known brain metastases are seen. MRI is suggested for further evaluation if clinical concern remains for acute CVA.