 Previously demonstrated multiple foci of diffusion signal abnormality have resolved. There are no new foci of restricted diffusion. There is a chronic appearing infarct is present in the subcortical white matter of the inferior frontal gyrus (series 303, image 172). Hemorrhagic products are now evident at a few of these foci of prior restricted diffusion consistent with hemosiderin deposition.There has been interval decrease in size of a right posterior parietal lesion, now measuring 16 x 23 mm in transaxial dimensions (previously 25 x 21 mm. This contains intrinsic T1 hyperintense material without significant associated residual enhancement. Postoperative changes are again noted secondary to a biopsy of this lesion.There is a new small focus of enhancement involving a posterior left insular cortex, in an area of prior stroke, and now associated with susceptibility abnormality.Confluent T2 hyperintense white matter abnormality has increased bilaterally, without associated mass effect, suggestive of treatment change.There is no significant mass effect or midline shift. The cerebellar tonsils are in normal position. The ventricles and sulci are unchanged in size. Flow voids are present within the major vessels indicating patency. Redemonstrated is diffuse sinus disease, with worsening of the frontal sinuses and left sphenoid sinus.
1.Previously demonstrated multiple foci of diffusion signal abnormality have resolved. There are no new foci of restricted diffusion.2.There has been interval decrease in size of a right posterior parietal lesion, now measuring 16 x 23 mm in transaxial dimensions (previously 25 x 21 mm. This contains intrinsic T1 hyperintense material without significant associated residual enhancement. 3.There is a new small focus of enhancement involving a posterior left insular cortex, in an area of prior stroke, and now associated with susceptibility abnormality. This is of uncertain clinical significance.4.Confluent T2 hyperintense white matter abnormality has increased bilaterally, without associated mass effect, suggestive of treatment change.5.Redemonstrated is diffuse sinus disease, with worsening of the frontal sinuses and left sphenoid sinus.