Reason: newly diagnosed lung cancer, initial staging, eval for mets History: none There is a small subdural effusion present in the posterior fossa suspected to be a result of some atrophy.There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are partially opacified left more than right. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.Quintanilla is made of some cystic lesions in the pharyngeal mucosal space and represent Thornwaldt cyst unchanged from the CT from 3/15/15
1.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related. 2.There is no evidence for brain metastases appreciated.