 The study is degraded by motion artifact. There are unchanged postoperative findings related to resection of a right superior temporal gyrus lesion. There is a new 5 mm enhancing lesion within the right cerebellar hemisphere with susceptibility effect and surrounding edema. There is also a new punctate focus of susceptibility effect with surrounding edema within the right occipital lobe although contrast enhancement is questionable given the motion degradation on the sequence. There are a few unchanged punctate scattered foci of susceptibility effect supratentorially that likely represent chronic microhemorrhages. The confluent periventricular T2 hyperintensity has minimally increased since the prior exam. There is no evidence of acute infarct. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. There is a retention cyst within the left maxillary sinus and minimal fluid within the left mastoid air cells.
1.Motion degraded exam. 2.New lesions within the right cerebellar hemisphere and the right occipital lobe may represent metastases or possibly acute - subacute microhemorrhages in the setting of prior whole-brain radiation. Given the motion artifact and limitations of the post-contrast sequences, repeating these sequences may be helpful for further characterization and would provide a more sensitive assessment for additional lesions.3.Unchanged postoperative findings related to resection of a right superior temporal gyrus lesion.4.Slightly increased confluent periventricular white matter signal abnormality is likely treatment related.