Female, 69 years old, with metastatic melanoma to the brain status post stereotactic radiosurgery. A hemorrhagic mass within the left inferior cerebellum and cerebellar tonsil is redemonstrated showing no significant interval change in size. The lesion induces strong susceptibility effect and contains pockets of internal T1 hyperintensity. Apart from this intrinsic T1 signal, little if any superimposed enhancement is seen internally. A thin uniform rim of enhancement has developed along the superior margin of the lesion. The degree of edema surrounding this lesion has slightly decreased.Chronic areas of hemosiderin staining and encephalomalacia are redemonstrated in the right parietal lobe, left occipital lobe, and within the left superior frontal gyrus showing no significant interval change. No new lesions are identified. No abnormal extra axial fluid collections are seen. A small focus of susceptibility is unchanged in the right cerebellum. Ventricular size and morphology are stable.
1.No significant change is seen in the size of a left cerebellar hemorrhagic lesion, though the associated edema has slightly improved. A thin rim of enhancement has developed along the superior margin of the lesion which is favored to be posttreatment in nature.2.Multiple additional areas of hemosiderin stained encephalomalacia are unchanged. No new intracranial lesions are detected.