Nasopharyngeal cancer, status post treatment, now with dysarthria, neck spasm, and left shoulder weakness. Brain: In addition to the previously demonstrated focus of susceptibility effect in the medulla, there are now numerous, on the order of 50, new intraparenchymal foci of infratentorial and supratentorial susceptibility effect. There is no evidence of acute infarct. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits are grossly unremarkable. The calvarium is intact. Neck: There are secretions in the posterior nasopharynx, but no evidence of measurable nasopharyngeal mass. The skull base appears to be intact. There is no significant upper cervical lymphadenopathy. The salivary glands appear unchanged. The major cervical flow voids are grossly intact. There is a posterior small disc osteophyte complex at C5-6.
1. Post-treatment findings in the nasopharyngeal region without evidence of measurable locoregional tumor.2. In addition to the previously demonstrated focus of susceptibility effect in the medulla, there are now numerous new intraparenchymal foci of infratentorial and supratentorial susceptibility effect, which could represent microhemorrhages, perhaps related to treatment effects, versus less likely atypical metastases. 