Multiple intra-axial haemorrhagic mass lesions demonstrated; largest within the right temporal lobe which has a fluid level measuring 60mm x 40mm causing effacement of the adjacent sulci, right uncal herniation and left sided midline shift with effacement of the right lateral ventricle. Other smaller intra-axial haemorrhagic mass lesions demonstrated within the left superior frontal gyrus (measuring 19 mm x 18 mm), the right posterior frontal lobe (measuring 48 mm x 32 mm) and the left mesial occipital lobe (measuring 10 mm x 11 mm). All the lesions demonstrate surrounding FLAIR high signal with effacement of the adjacent sulci.
Conclusion: Imaging appearance in keeping with multiple haemorrhagic metastases, largest within the right temporal lobe causing left sided midline shift and right uncal herniation.