History of lupus, presumed tuberculosis on treatment, with new cavitary brain and pulmonary lesions transferred from the MICU after initially presenting with 1 week of left sided weakness and hematemesis. There is interval decrease in size of a peripherally-enhancing lesion with central restricted diffusion in the periventricular region of the right frontal lobe, which measures up to 11 mm, preciously 13 mm. There is also decrease in the degree of surrounding vasogenic edema. There is also decrease in size of the peripherally enhancing right cerebellar hemisphere lesion, which measures up to 10 mm, previously 12 mm. There is also decreased vasogenic edema associated with this lesion. The left occipital lobe peripherally enhancing lesion is not significantly changes in size, measuring up to 6 mm, but the associated vasogenic edema appears to have diminished. There is decreased debris with restricted diffusion within the right lateral ventricle, but there appears to be more pronounced enhancement and T2 hyperintensity along the ventricular margin. Furthermore, the punctate focus of debris in the left occipital horn has resolved. The ventricular system is not dilated. There is no evidence of intracranial hemorrhage or acute infarct. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, and scalp soft tissues are grossly unremarkable. There is mild mucosal thickening in the left maxillary sinus.
Interval evolution of the multiple cerebral abscesses and ventriculitis, which appear to be largely subsiding.