Other convulsions [780.39] / Secondary malignant neoplasm of brain and spinal cord [198.3], Reason for Study: ^Reason: evaluate for tumor metastases, focal motor seizures LUE History: Cont. Keppra 500 mg bid as per verbal neurology consult There are multiple enhancing lesions including ring-enhancing lesion (14.3mm x 12.7mm) on the left post-central gyrus, irregularly enhancing lesion (14.3mm x 11.3mm) on the left pre-central gyrus and nodular enhancing lesion on the left the superior temporal gyrus with surrounding edema. The post central gyrus lesion shows susceptibility effects on gradient echo images indicate possible intra lesional hemorrhage or mineralization.Comparing to prior scan, both pre and post central gyri lesions appear to be increased in size and the left temporal lobe lesion is a new lesion.The ventricles, sulci and cisterns are symmetric and unremarkable. There is no acute ischemic or hemorrhagic lesion and the midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The mastoid air cells are clear.Right maxillary sinus shows opacification.
Interval increase in size of left pre and post central gyri lesions and a new nodular enhancing lesion on the left superior temporal gyrus which are consistent with multiple metastatic lesions.