Clinical question: Brainstem lesion, preop planning, surgery today. Signs and symptoms: Preop planning. Pre- and post enhanced fusion brain MRI:Examination is performed utilizing fusion protocol which is a limited study and not a true diagnostic test.Within this limitation the study demonstrate a focus of T2 hyperintensity in the anterior aspect of the pons and extending superiorly into the right Cipro peduncle without significant change since prior exam or detectable abnormal enhancement. The finding traverses the entire anterior aspect of pons measuring at 28 mm and 10 mm in AP axis. There is no appreciable associated mass effect with this finding.Additional focus of T2 hyperintensity with internal foci of mixed signal intensity and subtle patchy enhancement in the right thalamus without convincing evidence of interval significant change.Additional focus of extensive edema and ring-enhancing focus in the subcortical white matter of left posterior frontal is also noted. Patchy foci of enhancement within a focus of vasogenic edema involving the cortex and subcortical white matter of interhemispheric aspect of the left posterior frontal is also again noted noted without change.
Multiple foci of signal abnormality with surrounding vasogenic edema and patchy enhancement in bilateral cerebral hemispheres without significant change since prior exam as detailed/measured above.