Clinical question: CVA, TIA, hemorrhage. Signs and symptoms: Aphasia. Nonenhanced head CT:Examination again demonstrates as was noted on prior brain MRI of 24 hours earlier multiple foci of vasogenic edema consistent with multiple intracranial complement the study lesions. The lesion in the basal cistern demonstrate high density and likely representing known hemorrhagic component of tumor. The larger metastatic lesion in the left anterior frontal lobe demonstrates slightly higher than gray matter density also consistent with minimal internal hemorrhage. Mildly high density of vermian metastatic focus is also like lesion sulcal minimal internal hemorrhage.The rest of metastatic foci are evident only by edema without evidence of hemorrhage.There is evidence of regional mass effect at the level of metastatic lesions and without detectable mass effect on the ventricular system or midline shift.
1.Multiple foci of vasogenic edema consistent with patient's known intracranial metastatic lesions not significantly changed since prior exam from 24 hours earlier.2.Several of the lesions demonstrate slight increased density consistent with hemorrhage within the metastatic lesions as was noted on prior MRI.