46 years Female (DOB:10/4/1970)Reason: compare to prior MRI for brain mets History: NonePROVIDER/ATTENDING NAME: STEVEN J. CHMURA SERVICES ANCILLARY The patient status post left frontal craniotomy. There is encephalomalacia present along the left frontal lobe. It is unchanged compared to the prior exam.Patient is status post posterior fossa craniotomy. An enhancing lesion in the vermis has decreased in size compared to the prior exam. It currently measures 16 x 6 mm and previously measured 26 x 11 mm axial dimensions. There is associated enlargement of the fourth ventricle.A right paramedian pontine mass is present which measures 12 x 10 mm axial dimensions and previously measured 12 x 9 mm axial dimensions.There is a punctate right periventricular white matter enhancing lesion which is unchanged compared to the prior exam.There is a right occipital lobe lesion measuring 5 mm in diameter which previously measured the same is stable.There are FLAIR and T2 hyperintense lesions present in the left precentral gyrus, right frontal lobe and right temporal lobe which were also present on the prior exam and have not changed. These presumably related to previously treated lesions.Incidental note is made of a developmental venous anomaly in the right centrum semiovale.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.Since the prior exam an enhancing lesion in the vermis has decreased in size and presumably represents postoperative change.2.There are multiple lesions in the brain parenchyma one in the pons and another in the right occipital lobe and one in the right centrum semiovale which are stable compared to the prior exam. Presumably these are related to metastatic disease.3.Since prior exam a pontine mass has remained stable. This is suspicious for neoplasm.