Clinical question: History of lung cancer, evaluate for eye pain. Signs and symptoms: Left eye pain. Pre and post enhanced brain MRI:No acute intracranial process and negative diffusion weighted series.Changes consistent with mild chronic nonhemorrhagic small vessel ischemic strokes primarily in bilateral cerebral hemispheres demonstrate no interval change since prior study.Mildly prominent supratentorial ventricular system and the cortical sulci similar to prior exam. This finding although could be at the upper limits of normal for patient's stated age possibility of mild underlying parenchymal volume loss should also be considered.Post contrast images demonstrate no detectable abnormal enhancement of brain parenchyma or the leptomeninges.Unremarkable images through the orbits and including 3 mm thin axial fat sat post enhanced series.The signal intensity of the calvarium is within normal and without detectable abnormal enhancement.All paranasal sinuses and bilateral mastoid air cells and middle ear cavities demonstrate normal pneumatization signal patterns.The signal voids of major intracranial arterial branches are identified.The signal intensity of intracranial venous sinuses are within normal and with normal pattern of enhancement.
1.No acute intracranial process and no convincing evidence of new finding since prior MRI from February 2015.2.Stable mild chronic nonhemorrhagic small vessel ischemic strokes.3.Stable mildly prominent cortical sulci and supratentorial ventricular system.4.Negative images through the orbits and including thin axial post enhanced fat sat series.5.Calvarium, soft tissues of the scalp, paranasal sinuses and mastoid air cells are unremarkable.