47-year-old female with metastatic breast cancer to the brain. Evaluate for presence of new midline shift, lesions, edema. Chronic, large right subdural/epidural fluid collection is again noted with a small amount of more subacute blood layering dependently. Mass effect on the right cerebral hemisphere persists with mild effacement of the right lateral ventricle and approximately 6 mm midline shift to the left. Overall findings appear similar to most recent MRI study from 5/4/2010. Prominence of the left lateral ventricle as well as the periventricular and subcortical low attenuation in the left cerebral hemisphere appear similar to prior MRI as well. Low attenuation in left cerebellar hemisphere also correlates with previous MRI findings (stable).Catheter enters the right frontal skull through a burr hole and terminates in the right ventricle at the level of the foramen of Monroe (unchanged). The calvaria and skull base are otherwise radiographically normal. Note is made of a left maxillary retention cyst; otherwise the visualized paranasal sinuses and mastoid air cells are normally pneumatized.
Chronic, large right extra-axial fluid collection with stable mass effect and midline shift to the left. Accounting for differences in technique, findings are overall unchanged on comparison to most recent MRI from 5/4/2010.