Secondary malignant neoplasm of unspecified site [C79.9], Reason for Study: ^Reason: h/o metastatic melanoma with brain metastases and increased seizures/psychosis; eval for interval change of metastases/edema/hemorrhage History: see above Redemonstration of multiple peripheral enhancing intra axial lesions on bilateral hemispheres and bilateral cerebellar hemispheres indicating metastatic lesions, however, each enhancing lesions show overall decrease in maximum diameter as well as the extent of surrounding edema since prior scan.On gradient echo images, several of those lesions show increased extent of susceptibility artifacts indicating increased intra-lesional blood products such as interval intra-lesional hemorrhages.There is no new abnormal enhancing lesion.The ventricles, sulci and cisterns are symmetric and unremarkable. There is extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.
1. Interval decrease of multifocal intra axial metastatic lesions and the extent of surrounding edema since prior scan.2. Interval increase of intra lesional blood products since prior scan.3. No new abnormal enhancing lesion is seen.4. No evidence of acute ischemic lesion.