Metastatic pancreatic cancer. Acute pulmonary embolism. Right-sided weakness. Rule out brain infarct or hemorrhage. The study is mildly to moderately limited by patient motion.There is no gross intracranial hemorrhage but subsequent SWI imaging was not obtained because of patient's intolerance to the length of the examination. There is no evidence of mass, or acute infarct. There are multiple punctate and confluent areas of T2/FLAIR hyperintensity within the periventricular and subcortical white matter, which are nonspecific. Also, there is apparent T2-hyperintense signal in the right posterolateral aspect of the medulla without correlating FLAIR abnormality or diffusion restriction.The ventricles and basal cisterns are normal in size and configuration accounting for mild-to-moderate brain volume loss. There is no midline shift or herniation. The major cerebral flow voids are intact. The marrow is diffusely less fatty than expected which may reflect red marrow reconversion.
1.No evidence of mass, or acute infarct. No gross intracranial hemorrhage but the hemorrhage-sensitive sequence was not obtained because of patient intolerance.2.Nonspecific white matter lesions, greater than expected for patient's stated age. Differential diagnosis includes infectious/inflammatory etiologies, demyelinating disease, and chronic small vessel ischemic changes with a few chronic lacunar infarcts.3.Focal T2-hyperintense signal in the right posterolateral medulla without correlating FLAIR abnormality, which might be artifactual.