History of tectal glioma, evaluate for change. There are postoperative findings related to right transfrontal biopsy of a periaqueductal lesion with persistent susceptibility effect and T2 hyperintensity along the surgical tract related to prior hemorrhage. There is no significant interval change in the subcentimeter nonenhancing, T2 hyperintense lesion within the tectum. There are a few scattered punctate foci of increased T2/FLAIR signal within the periventricular white matter, not significantly changed. There is a new curvilinear focus of increased T2/FLAIR signal within the left cerebellar hemisphere with associated faint enhancement compatible with interval small lacunar infarct. There is no associated restricted diffusion to suggest acute ischemic infarction.The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or mass effect. No extra-axial fluid collection is identified. Normal flow-voids are demonstrated in the major intracranial vascular structures.Minimal mucosal thickening is present within the paranasal sinuses. The orbits and skull are grossly unremarkable.
1.Postoperative findings related to biopsy of a periaqueductal lesion, which has not significantly changed in size.2.Stable foci of nonenhancing white matter signal abnormality, with likely new now subacute small lacunar infarct in the left cerebellar hemisphere.