History of a GBM. Difficulty ambulating, weakness and vomiting. Since prior CT, there has been increased edema in the right posterior parietal with more mass effect on the right lateral ventricle, which has been completely effaced and the left lateral ventricle has been dilated. Also, there is a 16.4 mm leftward midline shift. The calcification within the edema is again noted. In addition, there are a hypodensity in the genu of corpus callosum and hyperdensity in the head of the left caudate, which are new findings since prior CT, however, are visualized on prior MRI dated 2/12/08 and now appear more pronounced. The left frontal encephalomalacia remains unchanged. No intracranial hemorrhage or abnormal extraaxial fluid collection is detected.
1. Interval increased right posterior parietal edema with increased mass effect causing effacement of the right lateral ventricle, hydrocephalus and a leftward midline shift, suggesting tumor progression. 2. Interval new abnormal densities in the genu of corpus callosum and in the head of the left caudate. These may represent tumor spreading. A brain MRI is recommended for further evaluation. 3. Stable left frontal encephalomalacia. 