 Again seen are postsurgical changes of a right frontal craniotomy with resection of a right middle frontal gyrus lesion. At the superior margin of the resection cavity, there is again a non-specific enhancing nodule which measures approximately 5 mm in greatest dimension. This has not significantly changed since the prior examinations dating back to 7/5/2016. There are foci of susceptibility artifact again seen within the surgical bed, likely related to hemosiderin deposition. A heterogeneous ring-enhancing lesion is again seen extending into the trigone of the right lateral ventricle, which measures 21 x 15 mm (series 1100, image 90) compared to 21 x 16 mm previously. Portions of the wall of the lesion again demonstrate restricted diffusion and enhancement, similar to the previous examination. Stable FLAIR signal abnormality surrounding the lesion is consistent with vasogenic edema. No new enhancing lesions are identified.Scattered foci of signal hyperintensity on FLAIR and T2-weighted images in the periventricular and subcortical white matter likely reflect chronic small vessel ischemic disease. There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. No abnormal extra-axial fluid collection is identified. There is no midline shift. The midline structures and craniocervical junction are within normal limits. Normal flow-voids are demonstrated in the major intracranial vascular structures.The paranasal sinuses are clear. The visualized mastoid air cells are clear. The orbits are unremarkable.
1.A right periventricular white matter lesion appears stable compared to the prior exam on 11/24/2016. No new enhancing lesions are identified.2.Stable appearance of the right middle frontal gyrus resection cavity.