55-year-old man with history of meningioma status post radiation therapy; surveillance. Patient has history of HIV infection. Again seen is a homogenously enhancing extra-axial lesion with dural tail along the left planum sphenoidale measuring approximately 13 x 8 mm on sagittal postcontrast images, unchanged as compared to prior exam of 2/24/2016. There continues to be mild local mass effect on the adjacent left gyrus rectus. There is no evidence of intracranial hemorrhage or acute infarct. Scattered patchy areas of T2/FLAIR hyperintensity in the periventricular white matter are nonspecific but may represent chronic small vessel ischemic disease or changes related to HIV infection, appearing similar to prior exam. 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, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
1.Stable exam, with no change in size of left planum sphenoidale meningioma as compared to exam from 2/24/2016.2.Stable foci of periventricular T2/FLAIR hyperintensities which are nonspecific but may represent changes related to HIV infection or chronic microvascular ischemic disease.