There is a 25 mm intraparenchymal hyperdense lesion within the left parietal lobe superiorly involving the motor and somatosensory cortex with adjacent vasogenic oedema. Another 12 mm intraparenchymal hyperdense lesion is seen within the right temporal lobe inferiorly with some minimal adjacent oedema. Both these lesions minimally enhance.
There are some periventricular white matter changes.
There is no midline shift. The basal cisterns are not effaced.
Conclusion
- bilateral hyperdense abnormalities which mildly enhance with adjacent vasogenic oedema. The appearance is concerning for haemorrhagic metastatic deposits. Common causes in an elderly male include melanoma, renal cell, lung and thyroid cancer.
- CT of the chest, abdomen and pelvis is recommended to assess for a possible primary and stage any further metastatic disease