Clinical question: History of lung cancer, compared to prior exam. Signs and symptoms: None. Nonenhanced brain MRI:No diffusion weighted abnormalities.Examination demonstrates interval improvement of postoperative changes of right frontal lobe tumor resection. There is interval decreased size of the small hematoma adjacent to the surgical cavity since prior study. Remaining hematoma on coronal T2 weighted images measures approximately 7.7 x 4-mm in size compared to prior study measurement of approximately 5.8 x 8-mm.there is also interval decreased size of surgical cavity demonstrating hemosiderin deposition along its wall since prior study. The surgical cavity measures approximately 6.7 x 8.7 mm in transaxial dimensions compared to prior study measurements of approximately 10 x 11 mm.Surrounding white matter T2 hyperintensity in the pattern of vasogenic edema all of without associated mass effect demonstrates subtle interval decrease extension.Extensive periventricular and pontine and to a lesser degree subcortical foci of flair hyperintensity suggestive of chronic nonhemorrhagic small vessel ischemic strokes are again noted. There are small foci of flair hyperintensity in the right inferior cerebellum consistent with chronic right cerebellar ischemic strokes without change. Ventricular system remain within normal size and it maintained midline.
1.Interval improvement of postoperative changes of right frontal surgery and hemorrhage as detailed/measured above.2.No evidence of any new foci of edema or mass effect.3.Findings suggestive of chronic small vessel ischemic strokes grossly similar to prior study.4.Right cerebellar chronic ischemic strokes without change since prior exam. Diffusion-weighted images remain negative.