55 years Male (DOB:6/5/1961)Reason: Re-evaluate for disease progression- known history of brain metastases with recent falls History: Stage IV melanoma with recent fallsPROVIDER/ATTENDING NAME: JASON JOHN LUKE JASON JOHN LUKE The patient status post right parietal craniotomy.There are numerous foci of the susceptibility effect scattered in both hemispheres of the brain and in the cerebellum without any significant contrast enhancement. Compared to the previous exam these do not appear to have changed one in the left parietal lobe currently measures 5 mm and previously measured the same.The patient is status post right-sided parietal craniotomy. There is encephalomalacia present along the right inferior parietal lobule extending to the right temporal lobe associated with susceptibility effect.There is redemonstration of diffuse periventricular and subcortical white matter confluent signal changes which were also present on the previous exams to a similar extent.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells demonstrate opacities in the right mastoid air cells. The visualized portions of the orbits are intact.
1.There are multiple hemorrhagic type lesions scattered throughout the brain which appear relatively stable compared to the exam from July. The patient is known to have metastatic melanoma to the brain.2.Extensive and diffuse white matter signal changes have been present on prior exams and are most likely treatment related.