70 year-old male with metastatic adenocarcinoma of the appendix with new right-sided headaches and some unsteadiness. No focality on physical exam. There is no evidence of intracranial hemorrhage, mass or edema. Mild diffuse hypodensities in a periventricular and subcortical distribution consistent with small vessel disease, age indeterminate. If there is clinical concern for acute ischemia, an MRI may be considered.The ventricles and basal cisterns are normal in size and configuration.The calvaria and skull base are radiographically normal. The visualized paranasal sinuses and mastoid air cells are normally pneumatized.
Small vessel disease, age indeterminate. If there is clinical concern for acute ischemia, an MRI may be considered.