Clinical question: hx brain met- f/u 6 months for change. Signs and Symptoms: none- surveillance imaging. Pre and post enhanced brain MRI:Examination redemonstrate a large focus of left anterior frontal cystic encephalomalacia and gliosis spanning the cerebral cortex and subcortical/periventricular white matter reaches the left frontal horn of the lateral ventricle. There is mild ex vacuo dilatation of the left lateral ventricle. The signal intensity, extending and the overall appearance of findings remains identical to prior exam and without evidence of residual or recurrence of tumor. A thick localized dural based enhancement with T2 hypointense signal pattern also remains identical in size, extent, pattern of enhancement and highly suggestive of dural/epidural scarring. The finding measures approximately 11 x 26 mm in transaxial dimensions are identical to prior study.Small focus of FLAIR hyperintensity in the left anterior temporal lobe laterally without enhancement remains similar to prior exam and highly suggestive of post surgical changes of left-sided craniotomy. There is mild prominence of cerebral cortical sulci similar to prior exam. CSF cisterns remain within normal and similar to prior exam.No detectable new foci of FLAIR/T2 signal abnormality or abnormal parenchymal, meningeal enhancement to suggest new metastatic lesions.Unremarkable calvarium other than expected postoperative changes of left sided craniotomy.Unremarkable images through the orbits including axial fat sat post enhanced series.Paranasal sinuses and bilateral mastoid air cells demonstrate normal pneumatization signal patterns.
1.Stable postoperative/treatment changes of the left anterior frontal tumor removal since prior exam. No evidence of residual or recurrence of tumor.2.Stable dural focus of enhancement in size and extent and consistent with postoperative changes in the left anterior frontal.