Diagnosis: Abnormal findings on diagnostic imaging of skull and head, not elsewhere classifiedClinical question: Eval for change in L CVA and eval for change in R meningioma.Signs and Symptoms: meningioma. The CSF spaces are appropriate for the patient's stated age with no midline shift.There is sulcal and gyral signal hypointensity on SWI present along the medial high convexities of the frontal lobes , right parietal lobe and adjacent right occipital lobe. A focus of susceptibility effect is present in the left frontal lobe subcortical white matter and gray matter at the level of the superior frontal sulcus associated with loss of volume indicative of encephalomalaciaThere is a moderate degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.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 demonstrate minor opacities. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. The eyeball lenses are thin.
1.Since the prior exam is no significant interval change. 2.There is redemonstration of a focus of encephalomalacia in the left frontal lobe . This is most likely related to prior infarction3.There is siderosis along the medial aspects of the frontal lobes and along the right parietal and occipital lobes.4.Periventricular and subcortical white matter changes of a moderate degree are nonspecific. At this age they are most likely vascular related. 5.There is no evidence for acute ischemic cerebral infarction.6.There is no evidence for intracranial mass lesion. There is no evidence for meningioma.