Metastatic thyroid carcinoma to brain, status post resection, SRS, with bitemporal visual field defects. This is a motion degraded exam. There are postoperative findings related to right occipital craniotomy. There is redemonstration of mild dural thickening along the posterior falx and right cerebral convexity, as well as patchy parenchymal enhancement measuring up to 12 mm in maximum dimension in the right paramedian occipital lobe. Allowing for the differences in technique and motion degradation, these findings remain grossly unchanged. There is confluent T2 hyperintensity along the margins of the resection cavity compatible with gliosis, similar to prior. No convincing new abnormal intracranial enhancement is identified. There are bilateral cerebral periventricular white matter hyperintensity, which may represent chronic small vessel ischemic disease and/or treatment effects, which are grossly unchanged. The ventricles and basal cisterns are prominent due to cerebral volume loss, but unchanged. There is no midline shift or herniation. The major cerebral flow voids are grossly intact. There are bilateral lens implants. The paranasal sinuses are grossly unremarkable. There is an unchanged T1 hyperintense focus in the left frontal calvarium, which likely represents a hemangioma.
No significant interval change in the posttreatment findings in the right occipital lobe and no definite evidence of new intracranial metastasis, although the exam is limited by patient motion.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.