Male, 11 years old, with history of GBM status post chemotherapy. Sequelae of a right frontal approach biopsy of the brainstem are redemonstrated. Volume loss and ill-defined T2 hyperintensity of the right posterior midbrain are unchanged. No pathologic enhancement is detected in this region or elsewhere. Several punctate foci of intrinsic T1 hyperintensity are redemonstrated in the pons without significant interval change. A small focus of ill-defined enhancement which was noted on the prior examination within the pons is no longer clearly appreciated.No evidence of new parenchymal edema or mass effect is seen. No abnormal extra-axial fluid collections are detected. No acute intracranial hemorrhage is noted. The ventricular system is normal in size and morphology.
Signal abnormality involving the right posterior midbrain, at the site of prior tumor, is unchanged with no evidence of new signal abnormality or pathologic enhancement to suggest progressive disease.Several punctate nonspecific foci of intrinsic T1 hyperintensity are also unchanged within the pons. A suspected small focus of enhancement within the pons as noted on the prior examination is no longer clearly identified.