Previously demonstrated left cerebellar lesion and signs of ventriculitis. Status post IV antibiotics for 6 days. Leukemia. Again seen is ependymal enhancement along the right frontal horn, and right greater than left occipital horns of the bilateral ventricles with associated diffusion restriction, most favored to represent ventriculitis with debris/pus in the right ventricle and not significantly changed since 6/3/2015. There is particular T2/FLAIR hyperintensity associated with the enhancement surrounding the right occipital horn similar to prior. Again seen is a peripheral nodular enhancing lesion in the left cerebellar hemisphere which demonstrates mild decrease in size, previously measuring 12 x 10 mm, now 10 x 8 mm. There is decrease in the previously seen associated restricted diffusion. Mild associated edema is similar to 6/3/2015. Again seen is leptomeningeal enhancement involving the surface of the bilateral left greater than right cerebellar hemispheres which is not significantly changed. There are scattered punctate foci of susceptibility artifact, likely representing hemosiderin deposition from chronic microhemorrhages and unchanged; these may be related to patient's history of DIC.No new focus of intraparenchymal edema or new fluid collection to suggest abscess or empyema. No new mass effect. No hydrocephalus. There is minimal mucosal thickening in the paranasal sinuses. Paranasal sinuses and mastoid air cells are otherwise clear.
Compared to 6/3/2015, there appears to be mild decrease in size of peripherally enhancing lesion in the left cerebellar hemisphere and decrease in associated restricted diffusion. These findings are compatible with mild decrease in size of abscess. Mild associated edema is not significant changed. Prominent enhancement involving the lateral ventricular walls with debris/pus suggestive of ventriculitis is not significantly changed. Leptomeningeal enhancement involving the cerebellar surfaces is also not significantly changed. Given history, some of these findings may be related to leukemia although the overall constellation of findings favors infection. Recommend continued follow-up. No new focus of edema, new abscess, or new empyema.