72 years Male (DOB:3/2/1943)Reason: metastatic NSCLC s/p SRS to a L frontal and L occipital lesion, now s/p SRS to R frontal and L occipital lobe History: assess for extent of diseasePROVIDER/ATTENDING NAME: STEVEN J CHMURA STEVEN J CHMURA The CSF spaces are appropriate for the patient's stated age with no midline shift. On susceptibility imaging there are foci of low signal present in the left and right frontal lobe as well as at the occipital horn of the left lateral ventricle. On FLAIR and T2 imaging the left frontal lobe lesion located in the left superior frontal gyrus is stable in appearance. It has a low signal rim, central signal hyperintensity and a small amount of T2 and FLAIR signal hyperintensity adjacent to it. The right frontal lobe orbital gyrus lesion is relatively small and low signal on T1 and T2 imaging. Measures approximately 5 x 2 mm axial dimensions. The lesion along the occipital horn of the left lateral ventricle is approximately 1 x 2 mm in size and is low signal on FLAIR and T2 imaging as well as T1 imaging. It is within the brain parenchyma adjacent and superior to the occipital horn of the left lateral ventricle.A punctate focus of susceptibility effect is redemonstrated in the right middle frontal gyrusThere is a T2 hyperintense and FLAIR hypointense punctate focus in the left middle cerebral peduncle is also stable compared to prior examsNo abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. The eyeball lenses are thin.
There are multiple intracranial hemorrhagic lesions present which are stable compared to the prior prior exam.