64 years Female (DOB:12/30/1951)Reason: Treatment planning for SRS to L temporal lesion History: Treatment planning for SRS to L temporal lesionPROVIDER/ATTENDING NAME: STEVEN J CHMURA STEVEN J CHMURA There is a 18 x 15 mm axial dimension ring-enhancing lesion adjacent to the trigone of the right lateral ventricle which previously measured 10 x 11 mm axial dimensions. Currently the central component is hypointense on T2 and has a slightly hyperintense appearance on T1 scout images. There are some patchy susceptibility weighted imaging signal loss associated with the lesion. There is vasogenic edema associated with the lesion appears to be greater on the current exam versus the prior exam from July 5. There is a small enhancing tract anterior inferior to this periventricular lesion presumably related to the stereotactic needle tract.Since the prior exam a right middle frontal gyrus surgical site has remained stable.The patient is status post burr hole placement along the right parietal bone and right frontal craniotomy.There is a small ring-enhancing focus in the left temporal lobe measuring 6 mm in diameter associated with some surrounding T2 signal hyperintensity. This is also stableThere is redemonstration of an enhancing punctate focus adjacent to the frontal horn of the left lateral ventricle.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. The eyeball lenses are thin.
1.Multiple intracranial lesions present. One in the right periventricular white matter is enlarged however the rest are stable compared to prior exam. 2.The patient is status post recent stereotactic surgery for the right periventricular white matter lesion which now has a larger appearance. The change in size may potentially be accounted for on the basis of blood products within the lesion.