57 year old female with fever. Evaluate for bleed. Bifrontal white matter hypoattenuation appears stable since prior exam and is most consistent with vasogenic edema secondary to known intraparenchymal metastases. Ill-defined round hypodensities just superior to the lateral ventricles correlate with known intraparenchymal metastases seen on recent MRI. Internal focus of hyperattenuation in left lesion is unchanged and could represent focus of calcification.There is no evidence of intracranial hemorrhage or edema. The ventricles and basal cisterns are normal in size and configuration.Large expansile mass originating from right frontal bone and involving right orbit walls obliterates the superior right nasal cavity and ethmoid air cells, consistent with presumed fibrous dysplasia. Intraorbital soft tissues and optic canal are unremarkable. Multiple lytic skull lesions consistent with patient's known metastatic breast cancer are not significantly changed. Complete opacification of the left maxillary sinus is unchanged.
1.No acute intracranial abnormality or hemorrhage. However, noncontrast CT is not sensitive in detecting infectious process or metastases.2.Focus of hyperattenuation in the left parasagittal intraparenchymal lesion is unchanged and likely represents focus of calcification versus hemorrhage of the metastases.3.Bifrontal white matter hypoattenuation consistent with vasogenic edema secondary to known brain metastases or postradiation change is unchanged.4.No significant change in right frontal skull mass most consistent with fibrous dysplasia.5.Stable multiple lytic skull lesions consistent with known metastases.