Clinical question: Preoperative MRI for stereotactic biopsy. Signs and symptoms: History of radiosurgery, see MRI report, the lesion larger. Pre-and post-enhanced fusion brain MRI:Examination redemonstrates a left posterior frontal -- parietal falcine meningioma measuring maximum of 23 x 24-mm in transaxial dimensions similar to prior exam. There is redemonstration of subtle extension of meningioma across the midline to the right without change. Extensive surrounding T2 hyperintensity and associated mass effect representing edema remains also similar to prior study. There is a band of T2 signal abnormality weight enhancement surrounds the tumor and suggestive of post treatment changes/radiation necrosis with all patient with change.There is also revisualization of a tiny superficially located enhancing mass without surrounding edema or mass effect in the left inferior temporal gyrus and measuring maximum of 7.6-mm in size.Revisualization of a stable enhancing focus within the right posterior temporal bone and measuring approximately 8.2 mm in size. Stable previously known left-sided arachnoid cyst in the posterior fossa with extension across the midline to the right paramedian area
1.No evidence of an acute or new finding since prior study.2.Stable left falcine meningioma, with stable surrounding signal changes and enhancement suggestive of postradiation changes/necrosis.3.Stable tiny enhancing tumor in the left inferior temporal gyrus suspicious for a cavernoma.4.Stable tiny focus of intraosseous enhancement in the right temporal measuring approximately 8.2 mm in size.5.Stable arachnoid cyst in the posterior fossa on the left and mid extension to right paramedian.