Head and neck cancer. Dry mouth. Head CT:There is no evidence of intracranial mass, hemorrhage or acute infarction. The enhancing focus in the left parietal lobe reported on the prior CT study is no longer well visualized. In this same area, there is subtle hypodensity, consistent with encephalomalacia, possibly from previous infarction. There are scattered areas of chronic infarction in the left cerebellum, left parietal lobe, right frontal lobe and right basal ganglia which are unchanged compared to prior study. There are new areas of hypodensity seen in the right frontal periventricular region, and at the left basal ganglia, with low density compatible with old infarctions that have evolved since the prior CT study. The lesion at the left basal ganglia was also seen on prior MRI brain of 9/26/2009. Scattered ill-defined cerebral white matter hypoattenuation is consistent with small vessel ischemic changes.Neck CT:The soft tissue thickening and asymmetry at the laryngeal region are unchanged compared to prior study. No pathological size lymph nodes, or necrotic lymph node is identified. Again noted is a diverticulum at the anterior aspect of the esophagus. There is degenerative disease of cervical spine. There is interval development of near-complete opacification of the right maxillary sinus, with mucosal thickening also seen in the left maxillary sinus.There are postsurgical changes in bilateral mastoid regions.
1. Multiple chronic infarctions in the brain as described above.2. Stable soft tissue asymmetry in the laryngeal region. No evidence of adenopathy.3. New bilateral maxillary sinus disease.