Diagnosis: Headache Weakness Malignant neoplasm of brain, unspecifiedClinical question: Evaluate for cerebral infarction or hemorrhageSigns and Symptoms: 13 yo F with supratentorial mass and left sided weakness There is redemonstration of heterogeneous signal intensity predominantly peripherally enhancing mass centered in the right cingulate gyrus with extension to the adjacent right half of the corpus callosum, the right paracentral lobule and right parietal lobe which measures 46 x 33 mm coronal dimensions, 39 x 34 mm sagittal dimensions and 40 x 49 mm axial dimensions which on the August exam measured 42 x 35 mm coronal dimension, 39 x 34 mm sagittal dimensions and 50 x 40 mm axial dimensions. There is some associated susceptibility effect on its periphery. Signal characteristics on FLAIR MRI have changed compared to the prior exam. There is some mild surrounding signal changes in the adjacent white matter.The patient status post parietal craniotomy which crosses the midline and is eccentric towards the left sideNormal 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 demonstrate mild mucosal thickening. The visualized portions of the mastoid air cells demonstrate some scattered opacities. The visualized portions of the orbits are intact.
The patient's mass centered in the region of the right cingulate gyrus extending to adjacent brain tissue ase detailed above appears to be stable compared to prior exam from August.