Breast cancer 10 years ago and new cognitive decline: memory decline and minor hallucinations. There is disproportionate dilatation of the third and lateral ventricles with respect to the sulci. There is diffuse periventricular white matter T2 hyperintensity. There is an enhancing, dural-based right petroclival mass that measures up to approximately 2 cm. There are small areas of encephalomalacia in the right cerebellar hemisphere. There is no evidence of intracranial hemorrhage or acute infarct. There is no midline shift or herniation. The major cerebral flow voids are intact. The skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable. There are bilateral lens implants.
1. Findings suggestive of normal pressure hydrocephalus, with what may represent transependymal flow of cerebrospinal fluid and/or chronic small vessel ischemia.2. A right petroclival mass likely represents a meningioma and less likely a metastasis.3. Chronic lacunar infarcts in the right cerebellar hemisphere. 