History of a non-small cell lung carcinoma with brain metastasis and on coagulation. Altered mental status. Examination demonstrates multiple hypodensities in the right frontal lobe and basal ganglia, which are compatible with findings on the prior MRI. New since prior exam is a hypodense area in the right posterior temporal lobe, which involves the cortex. No evidence of intracranial hemorrhage, mass effect, midline shift or extraaxial fluid collection is identified. The ventricles are normal in volume. Deformity of the right lamina papyracea is present. Sinus disease is present. The calvarium is intact.
1. No evidence of intracranial hemorrhage. 2. Multiple right frontal and basal ganglia hypodensities likely represent metastases given clinical history and prior MRI provided. An infused MRI is suggested for further evaluation. 3. Right posterior temporal hypodensity likely represents ischemia, however, metastasis cannot be ruled out based on the current noninfused exam. 4. Right lamina papyracea dehiscence or blowout fracture. Please correlate clinically. 