83-year-old male patient with grade III oligodendroglioma status post resection, RT, and TMZ. There are stable post-operative changes of a right anterior temporal lobectomy with unchanged T2 signal abnormality surrounding the resection site extending to the right basal ganglia. There is no abnormal enhancement surrounding the right temporal resection cavity. Two new small foci of enhancement within the left paramedian cerebellar hemisphere which demonstrate correlating T2 hyperintensity. No other new or pathologic intracranial enhancement is seen. There is no restricted diffusion. Encephalomalacia involving the left anterior frontal lobe, and to a lesser degree the right inferior frontal lobe, appears similar to the prior study. Scattered periventricular and subcortical abnormal T2 signal may represent chronic small vessel ischemic disease and/or post-treatment related white matter changes. A focus of susceptibility within the left frontal lobe white matter is unchanged. The ventricles are unchanged in size. There is no midline shift or herniation. The major cerebral flow voids are intact. There are scattered tiny maxillary sinus mucous retention cysts.
1. Stable post-operative changes of a right anterior temporal lobectomy without definite evidence of tumor recurrence.2. Two new foci of enhancement within the left paramedian cerebellar hemisphere are non-specific and could potentially be vascular/ischemic in nature; attention on close follow up imaging is suggested.3. Stable periventricular and subcortical T2 signal abnormality which may represent chronic small vessel ischemic disease and/or post-treatment related white matter changes.4. Areas of frontal lobe encephalomalacia appearing similar to the prior study.