Clinical question: History of brain metastases. Compared with prior exam. Signs and symptoms: None. Pre-and post-enhanced brain MRI:A previously measured 5.8-mm left occipital lobe medullary hemorrhagic metastatic lesion demonstrate interval decreased size and measuring at 2.7-mm. No surrounding edema however minimal or mass effect.A right posterior temporal subcortical metastatic lesion which measured 5-mm on prior exam demonstrates interval decrease size and measuring at 1.9-mm. No surrounding edema or mass effect.A right posterior temporal metastatic lesion is remeasured at 9.2-mm on prior exam demonstrate interval decreased size and measuring at 8.3-mm on current study. The minimal internal hemorrhagic changes and surrounding edema however demonstrate no significant change.The largest metastatic lesion is at the level of the trigone of left lateral ventricle and inseparable from the ventricle wall. It measures at 8-mm and post-enhanced images compared to prior study measurement of 9.8-mm areaa punctate focus of enhancement pain in right posterior parietal lobe which measured at 2.4-mm demonstrate subtle interval decrease size and measuring at 1.7-mm. Post operative changes of high convexity right lateral frontal craniotomy with expected dural thickening and enhancement demonstrates no change. Focus of encephalomalacia at the site without abnormal enhancement is also again noted without change.Stable normal size of ventricular system and maintained midline.No detectable calvarial or orbital abnormal enhancement.
Redemonstration of multiple previously known brain metastatic lesion with further interval decreased size as detailed/measured above.