 There is no evidence of intracranial mass, acute infarct, mass effect or herniation. There is persistent ill-defined enhancement in the postsurgical area in the left frontal lobe, likely post-operative, without new or nodular enhancement. Previously seen tiny focus of high DWI signal in the right periatrial white matter is no longer present. There are stable postoperative findings related to left sided craniotomy with foci of encephalomalacia in left frontal lobe, and left occipital lobe with stable ex vacuo dilatation of the trigone of the left lateral ventricle.There is moderate degree of confluent periventricular and subcortical white matter T2 prolongation which is unchanged. Aside from differences in technique, there is redemonstration of numerous foci of punctate small susceptibility effect in the pons, cerebellar hemispheres, and bilateral cerebral hemispheres including the basal ganglia. There are stable small bilateral subdural effusions in the posterior fossa which may be secondary to volume loss. There is a small right maxillary sinus mucous retention cyst. There is new patchy increased T2 signal in the left mastoid air cells.
1.No evidence of intracranial metastases.2.Stable foci of encephalomalacia left frontal and occipital lobes.3.Stable nonspecific periventricular and subcortical white matter changes which may be related to posttreatment change or possible underlying chronic small vessel ischemic changes.