Glioblastoma. On Avastin. The study is at least moderately limited by patient motion. Besides hemosiderin staining along the margin of the surgical cavity in the inferior right temporal lobe, there is no intracranial hemorrhage. There is no acute infarct. Accounting for the significant limitation caused by motion on today's examination, irregular faint contrast enhancement along the surgical margin and adjacent parenchyma in the right temporal lobe has not grossly changed in extent. It still involves the body of the right hippocampus and reaches to the trigone of the lateral ventricle. It is associated with mildly restricted diffusion. There is no definitive new contrast-enhancing brain lesion. The ill-defined periventricular T2-hyperintensity involving the right hemispheric cerebral white-matter has slightly increased in extent. The less extensive periventricular T2 intensity in the left cerebral hemisphere is not changed. There are changes related to the known infarct involving the posterior limb of the right internal capsule on the right. The ventricular system continues to be moderately dilated as well as the sulci and basal cisterns, reflecting parenchymal volume loss.Dynamic susceptibility-weighted contrast-enhanced MR perfusion imaging was performed but the study is degraded by gross motion.
1.The study is at least moderately limited by patient motion.2.The thick rim of faint contrast enhancement related to the right temporal resection cavity is grossly unchanged since February 2016. 3.Probable treatment related white matter signal abnormality continues to progress slowly on the right.