59 years Female (DOB:5/2/1956)Reason: history of brain mets s/p RT History: nonePROVIDER/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 3 mm enhancing focus along the left parietal lobe in the superior parietal lobule which is also identified on the prior exam and appears similar in size.. A couple punctate foci of enhancement present in the left middle frontal gyrus which are stable compared to the prior exam. There is a punctate focus of enhancement in the right orbital gyrus along its medial aspect which is also present on the prior exam and is stable. There are a couple punctate lesions present in the right inferior parietal lobule which are stable compared to the prior exam .On susceptibility imaging there is a punctate focus of signal loss in the left inferior parietal lobule which is not associated with contrast enhancement in those also present prior exam. An additional nodular focus of signal loss and susceptibility is present in the right precentral gyrus.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.
There is redemonstration of multiple tiny lesions in the supratentorial brain which are compatible with metastatic disease. These appear stable compared to the previous exam.