Female, 66 years old, with history of GBM, anemia and check point there is, status post recent fractionated SRS to the basal ganglia lesion. Findings are redemonstrated compatible with prior left occipital lobe resection. The surgical cavity size and morphology, as well as the surrounding T2 hyperintensity, are not significantly changed from prior. No concerning enhancement is seen within or around this cavity.Also redemonstrated is evidence of left anterior temporal resection. The surgical cavity contains heterogeneous T1 and T2 hyperintense material compatible with mixed fluid and blood product. Mild dural enhancement is evident along the craniotomy margin but no convincing pathologic enhancement is seen beyond the intrinsic T1 hyperintense signal.Since the prior examination, T2 hyperintensity involving the left inferior basal ganglia and posterior limb of the internal capsule has expanded and become less well-defined. However, the degree of associated pathologic enhancement has decreased substantially.No additional significant or new areas of parenchymal signal abnormality or pathologic enhancement are identified. A few scattered small foci of white matter T2 signal abnormality in the cerebral hemispheres are unchanged. The ventricular system is stable in size and morphology including ex vacuo dilatation of the left lateral ventricle. The previously seen extradural fluid collection along the left temporal craniotomy flap has decreased in thickness. The right maxillary sinus remains opacified secretions and mucosal thickening.
1.T2 signal abnormality within the left inferior basal ganglia has increased in geographic extent but appears more ill-defined than on the prior examination with significantly reduced pathologic enhancement. Findings likely reflect response to radiotherapy if indeed this was the targeted lesion.2.Stable appearance of the left anterior temporal resection cavity which contains a heterogeneous mixture of fluid and blood product.3.Stable appearance of the left occipital resection cavity.