Altered mental status, unspecified [R41.82], Reason for Study: ^Reason: AMS; eval for leptomeningeal spread; NSCLC w mets to brain s/p recent stereotactic brain XRT History: see above There are a couple of focal enhancing lesion on the left posterior temporal lobe which are new lesions not seen on Apr 5 2016.Right frontal white matter lesion (series 12, image 9), right middle frontal gyrus (series 12, 7) image are seen, unchanged since prior scan.The right occipital intraaxial mass which abuts dura shows interval decrease in size since prior scan.  Patchy FLAIR high signal intensities on periventricular white matter indicating non specific small vessel ischemic lesions are seen, unchanged.The ventricles, sulci and cisterns are symmetric and unremarkable. The midline structures and cranial-cervical junction are normal. The paranasal sinuses and mastoid air cells are clear.
1. Interval development of new nodular enhancing lesions on the left posterior temporal lobe.2. Interval decrease in size of the right occipital lobe lesion since prior scan.3. Small nodular enhancing lesions at the right frontal lobe do not show any significant interval change. 