56 years Male (DOB:4/20/1960)Reason: memorry changes, hx of heart transplant, mood changes, left sided headache History: left sided headache, mood changes, immunosuppressedPROVIDER/ATTENDING NAME: GENE H. KIM GENE H. KIM The CSF spaces are appropriate for the patient's stated age with no midline shift. There is redemonstration of multiple punctate foci of signal loss along the periventricular and subcortical white matter as well as the left thalamus.On coronal T2 imaging there is redemonstration of a right parotid mass which can also be identified on sagittal T1 imaging. It does not appear to have changed substantially when compared to prior exams there is not entirely included on this exam. It measures approximately 3 cm in size. It has been present on prior exams and although it has not changed since the prior exam there appears larger than on the 2012 exam when it measured 20mm x 15 mm coronal dimensions.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 demonstrate some mucosal thickening in the left maxillary sinus The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.Redemonstration of multiple microhemorrhages scattered in the supratentorial white matter as well as the left thalamus. This is relatively stable. Etiology is unclear on the basis of this exam.2.Redemonstration of a right parotid mass which is not adequately imaged on this exam. It has been present on prior exams and although it has not changed since the prior exam there appears larger than on the 2012 exam.3.No intracranial mass lesions are appreciated.