76-year-old female with glioblastoma. Three weeks into RT. Decreasing mental status and increasing somnolence. Recent fall. Evaluate for bleed, shift or edema Minimal edema and hemorrhage at the site of patient's known left temporal lobe tumor and postoperative site is noted. Extensive periventricular and subcortical areas of low attenuation is believed to represent advanced small vessel disease of indeterminate age. A very small area of increased density measuring approximately 3 mm in left parietal is concerning for small amount of hemorrhage. No subarachnoid hemorrhage or midline shift or hydrocephalus.Postoperative changes of calvarium are noted in calvarium is otherwise unremarkable.Limited view of paranasal sinuses and mastoid air cells are also unremarkable.
1.Diffuse a small vessel disease of indeterminate age.2.Small area of hemorrhage edema and postoperative change in the left temporal lobe which were present on prior MRI.3.Very small area of suspected hemorrhage in the parenchyma in the left parietal which is a new finding.