Clinical question: History of head and neck cancer with brain metastases status post SRS, surveillance MRI. Signs and symptoms: None. Pre and post enhanced brain MRI:Negative diffusion weighted series.Examination demonstrates significant interval improvement of postoperative changes of left temporal lobe surgery for removal of tumor. There is significant interval decreased postoperative enhancement at the site with trace residual enhancement. Examination also demonstrates significant interval decreased parenchymal FLAIR hyperintensity at this site.There is no detectable abnormal parenchymal or leptomeningeal enhancement to suggest new metastatic disease since prior exam. Stable few punctate nonspecific FLAIR hyperintensity in the periventricular and subcortical white matter of cerebral hemispheres. There is revisualization of a tiny left anterior frontal developmental venous anomaly without detectable associated cavernoma.Unremarkable cerebral cortex, cortical sulci, ventricular system and CSF spaces otherwise for age.Unremarkable calvarium other than expected postoperative changes of prior left sided craniotomy.Unremarkable images through the orbits and including axial fat sat post enhanced images.All paranasal sinuses and bilateral mastoid air cells demonstrate normal pneumatization signal pattern.
1.No acute intracranial process and negative diffusion weighted series.2.Significant interval improvement of postoperative changes of left temporal lobe without residual tumor.3.No detectable metastatic lesion of the brain, leptomeninges or the calvarium.4.Stable few punctate nonspecific FLAIR hyperintensity in bilateral cerebral hemispheres.5.Revisualization of a tiny left anterior frontal developmental venous anomaly without associated cavernoma.