 There are multiple supratentorial and infratentorial lesions with variable enhancement, many showing susceptibility effect consistent with hemorrhagic products, which are compatible with metastases. Aside from the calcified right hippocampus lesion, a peripherally enhancing left superior frontal gyrus lesion, and the dominant peripherally enhancing lesion in the inferior right parietal lobe, which are not significantly changed, the other lesions have decreased in size and display less prominent enhancement. For example, a left cerebellar hemisphere lesion measures up to 4 mm, previously6 mm, a left medial temporal lobe lesion measures up to 6 mm, previously 9 mm, a left temporal lobe lesion measures up to 7 mm, previously 12 mm, and a right cuneus lesion measures up to 3 mm, previously 14 mm. In addition, there has been interval decrease in the degree of associated vasogenic edema overall. There is consequent decreased mass effect on the posterior horn and atrium of the lateral ventricles, right greater than left and there is no significant midline shift. There is a background of punctate T2 hyperintense signal abnormality scattered in the supratentorial periventricular and subcortical white matter, which is nonspecific. There is no evidence of acute infarct. The orbits, skull, and scalp soft tissues appear unremarkable.
Stable to decreased size of the intracranial metastases and overall reduced associated vasogenic edema.