History of lung cancer with brain metastasis. The multiple supratentorial brain lesions have decreased in size and are now all subcentimeter. For example, a left parietal lobe lesion measures up to 7 mm, previously 9 mm. The T2 hyperintensity surrounding the metastases has also diminished. There is residual susceptibility effect associated with some of the lesions. However, there is new patchy restricted diffusion in the left parietal lobe with high T2 signal. The ventricles and sulci are stable. Otherwise, patchy and confluent periventricular and subcortical white matter T2 hyperintensity is similar to the prior exam. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable. There is fluid signal in the mastoid air cells bilaterally.
1.The multiple brain metastases have generally decreased in size since June 2015. Comparison with the brain MRI from July 2015 is otherwise limited due to the extensive motion artifact on that scan.2.Recent infarct involving the left parietal lobe superimposed upon a background of chronic small vessel ischemic disease.Findings discussed with Dr. Salgia by phone at 4:30pm on 10/14/2015.