 Redemonstrated are lesions of low susceptibility signal, a few with corresponding T1 hypointensity and less conspicuous central T2 hyperintensity dispersed throughout the brain, which are unchanged from the previous study except for the lesion seen previously in the left frontal lobe which has increased in size from 4 mm to 7 mm demonstrating new perilesional edema and enhancement.Punctate nonspecific foci of T2 and FLAIR high signal are again seen in the corona radiata and the centrum semiovale, unchanged from the previous study.The ventricles and sulci are within normal limits. The basilar cisterns remain patent. There is no midline shift or mass effect. No extra-axial fluid collection is identified. Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. There is mild mucosal thickening in the maxillary sinuses. The left parotid gland is again diminutive in volume, which may be postoperative or post treatment in nature.
1.A left frontal lobe lesion has increased in size with new perilesional edema and new enhancement. The constellation of these features are worrisome for progression of a metastasis and less likely changes within a cavernoma.2.The remainder of the previously identified lesions are unchanged.