History of acute lymphocytic leukemia. Status post chemotherapy and cranial radiation. Follow-up of a small right frontal extra-axial contrast-enhancing lesion. The examination is limited because of the presence of the vagal nerve stimulator which technically limits the examination.While neck MRI was also requested, test sequence was performed and the neck was completely obscured by lack of signal.There is no evidence of acute intracranial hemorrhage, mass, or acute infarct. Foci of susceptibility effect overlying the right parietal lobe and the undersurface of the left temporal lobe remain unchanged. T2 FLAIR hyperintensity in the periventricular cerebral white-matter remain unchanged and probably reflects previous treatment. The dural-based right frontal contrast-enhancing lesion has not changed, measures transaxial 1.3 cm x 0.9 cm and is most compatible with a small meningioma. Minimal adjacent skull change is present but no gross erosion. There is no abnormal intracranial enhancement otherwise. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits and scalp soft tissues are grossly unremarkable. There is mild mucosal thickening in the paranasal sinuses.
1.Examination is limited because of the vagal nerve stimulator.2.No acute intracranial findings and no convincing evidence of new finding since prior study.3.Unchanged mild T2 FLAIR hyperintensity in the cerebral white-matter, most likely represent post therapy change. 4.The small right frontal, dural based contrast-enhancing lesion is unchanged and most probably represents a small convexity meningioma.