62 years Male (DOB:11/14/1954)Reason: evaluate for blood versus laminar necrosis History: h/x GBMPROVIDER/ATTENDING NAME: JAMES A. MASTRIANNI The CSF spaces are appropriate for the patient's stated age with no midline shift. The patient is status-post right-sided craniotomy. There is a focus of encephalomalacia centered in the right temporal lobe. There is associated T2 and flair signal change within and temporal lobe and enlargement of the trigone of the right lateral ventricle. There is some T1 hyperintensity as well as some patchy contrast enhancement in the right temporal lobe. This appearance was also present on the prior exam from March and does not appear to have changed significantly. There is relatively decreased cerebral blood volume on perfusion maps within this region. Cerebral blood volume maps do not demonstrate any foci of increased perfusion, however, susceptibility imaging demonstrates some small serpiginous signal voids.There is a mild degree of periventricular and subcortical confluent hyperintense white matter lesions present identified on the FLAIR and T2 images. This is likely treatment related.There are punctate foci of signal loss and susceptibility imaging involving left thalamus and right temporal lobe. These are stable compared to prior exam.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 mucosal thickening. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.The patient is status post right temporal lobe surgery for removal of a neoplasm.2.There is abnormal signal within the right temporal lobe and decreased perfusion to the right temporal lobe. Since the prior exam there has been no significant interval change. 