Unspecified convulsions [R56.9], Reason for Study: ^Reason: Evaluate for metastatic lesions History: History of breast CA, presenting with seizure and bilateral masses on HCT There are multifocal variable sized round enhancing lesions on bilateral hemispheres, brain stem as well as cerebellum. There is an enhancing lesion based on the left side falx around the area of the left postcentral gyrus. Most of these lesions show restricted diffusion with surrounding edema. Constellation of above findings indicate multifocal brain metastasis with surrounding edema.Bilateral lateral ventricles show effacement due to mass effects with minimal midline shift toward left side.There are nodular conglomerated susceptibility lesions on the left thalamus without evidence of T1 high signal intensity nor evidence of enhancement indicating possible chronic hemorrhages. Patchy FLAIR high signal intensities on bilateral periventricular white matter indicate underlying non specific small vessel ischemic disease. The midline structures are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.
1. Multifocal bihemispheric, supra and infratentorial metastatic lesions as described above with minimal midline shift toward left side. 2. Underlying non specific small vessel ischemic disease.