Reason: 3 t scanner s/p crani for tumor resection History: surveillanceAdditional history EMR: non-small cell lung cancer status post surgery for a cerebellar lesion, SRS and WBRT. She was recently found to have a small right frontal lesion which is biopsied July 2016 with pathology consistent with gliosis. There is extensive susceptibility along the right frontal and left occipital/suboccipital regions. This relates to a previous right pterional craniotomy and multiple surgical/aneurysm clips along the right sphenoid wing, multiple bilateral burr holes and placement of a posterior fossa drainage catheter. Additional postoperative changes are seen from a right parietal craniotomy for a resection of a right precentral gyrus lesion. A small somewhat ill-defined focus of enhancement along the precentral gyrus appears similar to the preoperative examination with associated T2/FLAIR hyperintensity within the white matter.There remains diffuse pachymeningeal enhancement and dural thickening. Loculated subdural collections along the frontal lobes appears similar, measuring just under a centimeter in greatest thickness.The previously demonstrated shunted lesion within the medial left cerebellum shows no significant interval change. There is associated FLAIR hyperintensity with a central area of irregular enhancement which measures up to 13 mm in greatest axial dimension. A nonenhancing area of T2 signal abnormality within the left middle frontal gyrus appear similar. Other scattered nonspecific foci of T2/FLAIR hyperintensity are seen within the cerebral white matter, remaining nonspecific but stable. The ventricles are stable in size, with evidence of global volume loss. Incidental partially empty sella is again noted.
1.Stable postoperative changes following previous right precentral gyrus lesion biopsy. Minimal irregular enhancement along this site with associated FLAIR hyperintensity appears similar to the preoperative study.2.An irregular enhancing lesion within the left medial cerebellum and a nonenhancing FLAIR hyperintense lesion within the left middle frontal gyrus appears similar. No new intracranial lesions are seen.3.Persistent bilateral somewhat loculated frontal subdural collections are unchanged. Stable diffuse pachymeningeal enhancement and thickening.