73 years Female (DOB:8/15/1943)Reason: glioblastoma History: glioblastomaPROVIDER/ATTENDING NAME: STEVEN J. CHMURA STEVEN J. CHMURA The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a T2 and FLAIR hyperintense lesion involving the left hippocampus and adjacent choroid associated with peripheral contrast enhancement. This is associated with punctate foci of signal loss on susceptibility imaging within the left hippocampal lesion. It measured 17 mm width on the prior exam and measures 19 mm with on the current exam. It appears to extend further posteriorly on the current exam. The temporal horn of the left lateral ventricle appears to be slightly dilated. There is associated elevation of cerebral blood volume with this lesion.There is a 29 x 32 mm axial dimension focus of signal hyperintensity extending from the ependymal lining of the left lateral ventricle into the centrum semiovale as well as the body of the corpus callosum which previously measured 25 x 22 mm axial dimensions. Additionally, there is T2 and FLAIR signal hyperintensity present within the splenium of the corpus callosum which is stable and in a focus measuring 19 x 17 mm in the right inferior parietal lobule which previously measured 14 mm. Additionally there is T2 and FLAIR signal hyperintensity present along the right hippocampus and a 6 mm lesion present within the left superior frontal gyrus which have not significantly changed. Within the larger lesions are associated elevation of cerebral blood volume.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.There are multiple lesions present within the brain parenchyma as detailed above some of which have increased in size and others which have not. In particular lesion present within the left hippocampus and choroid region has a more aggressive appearance and has enlarged and is associated with widening of the involved left lateral ventricle. This is consistent with the diagnosis of glioblastoma and could represent primary multifocal neoplasm.