53 years Female (DOB:6/14/1962)Reason: brain mets with cystic lesions s/p drain placement and whole brain rt History: eval for extent of diseasePROVIDER/ATTENDING NAME: STEVEN J CHMURA STEVEN J CHMURA A ring-enhancing fluid collection present in the right temporal lobe lobe measures currently measures 25 x 21 mm axial dimensions and 18 x 23 mm coronal dimensions. It previously measured 21.3 mm x 25 mm axial dimensions 25 x 20 mm coronal dimensions. This lesion abuts the right lateral ventricle. There is a drainage tube which courses through the right temporal lobe into the lateral aspect of this lesion adjacent to the lateral ventricle.A lesion centered in the left postcentral gyrus currently measures 17 x 10 mm axial dimensions and previously measured 47 x 33 mm axial dimensions. A drainage tube courses to the left parietal lobe into this lesion and subsequently into the adjacent white matter of the centrum semiovale.A right frontal lobe ring-enhancing lesion measures 5 mm on the current exam and previously measured 8 mm x 9 mm. On the 10/15/2015 exam it measured 8 mm x 9 mm. There is no associated diffusion restriction within these fluid collections. Fluid collections have high signal on T2 and FLAIR imaging within them. There is surrounding halo of edema with each of these ring-enhancing lesions.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are opacified. The visualized portions of the orbits are intact.
1.Since prior exam a right temporal lobe ring-enhancing lesion has mildly decreased in size. 2.The left parietal lobe lesion has dramatically decreased in size. 3.A the right frontal lobe lesion remains stable in overall dimensions.4.The patient is status post catheter placement in the left frontal lobe cystic lesion as well as the right temporal lobe lesion through adjacent burr holes.