53-year-old male with meningioma, evaluate for progression surveillance A small left parietal convexity dural-based contrast enhancing mass has not changed. It has a maximum thickness of less than 5 mm. As before, there is no significant significant mass effect.Diffuse T2/FLAIR signal abnormality involving the deep gray nuclei, bilateral pons (with downward extension into the ventral medulla), left greater than right thalami as well as scattered foci of cerebral white matter remain unchanged. There is no diffusion restriction or susceptibility artifact. This most likely represents chronic microvascular ischemia. There is no space-occupying or contrast-enhancing brain lesion otherwise. The CSF-containing spaces are mildly expanded, reflecting mild volume loss. Major intracranial vessels are patent.Mild mucosal thickening in the right major sinus without fluid is unchanged. The other paranasal sinuses are clear. Remote small right orbital medial wall blowout fracture is unchanged with herniation of the extraconal fat into the ethmoid sinuses but no extraocular muscle entrapment.
1.A tiny left parietal convexity meningioma has not significantly changed.2.The relatively extensive and symmetric T2 signal abnormality primarily involving the deep gray nuclei and pons is not significantly changed since the previous examination. As discussed previously, this may be sequela of prior osmotic demyelination or other toxic-metabolic injury.