57 years, Female, post brain biopsy. History of breast cancer and AML. Again seen are postsurgical changes of biopsy of left occipital intraparenchymal hemorrhagic lesion via burr hole. There has been evolution of the signal features of the blood products as well as slight decrease in size of the lesion, which measures approximately 2.2 x 2.8 x 2.3 cm, previously 3.2 x 3.2 x 3.1 cm. Surrounding vasogenic edema has resolved. There is intrinsic T1 hyperintensity related to late subacute hematoma without definite enhancement.No restricted diffusion to suggest acute ischemia. There is a punctate focus of susceptibility in the right ventral pons likely representing a chronic microhemorrhage. No new intracranial mass or mass-effect. The ventricles are within normal limits in size and configuration. There is a 9 x 7 mm small pineal cyst which remains unchanged. Few scattered foci of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with mild chronic small vessel ischemic changes and/or posttreatment-related changes. Brain parenchyma is otherwise unremarkable for age. No abnormal parenchymal or meningeal enhancement. Major flow-voids are preserved. No destructive lesions within the calvarium.
1. Interval evolution of left occipital intraparenchymal hematoma with decrease in size and resolution of surrounding edema. There is no convincing evidence of metastatic disease in the brain; however, given the hemorrhagic nature of the lesion which may potentially obscure enhancement, consider an additional follow-up study. 2. Punctate focus of chronic microhemorrhage in the right pons. 