Lung mass, evaluate brain metastases. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is mild diffuse cerebral volume loss. There is a subcentimeter focus of encephalomalacia in the left caudate. There is also mild scattered cerebral white matter T2 hyperintensity. There is no midline shift or herniation. The major cerebral flow voids are intact. The skull and scalp soft tissues are grossly unremarkable. There are bilateral lens implants. There is a retention cyst or secretions in the right ethmoid air cells.
1. No evidence of acute intracranial mass, although the lack of intravenous contrast limits the assessment for metastatic disease. (A minor contrast extravasation occurred and further attempts for intravenous line insertion were declined.)2. Probable chronic small vessel white matter ischemic disease and a chronic left caudate lacunar infarct.