Evaluate for the growth of NSCLC brain metastases. There are postoperative findings in the left parietal lobe with persistent confluent T2 hyperintensity surrounding the resection cavity, but no evidence of recurrent tumor in this area. However, punctate foci of enhancement and susceptibility effect in the medial temporal lobe anteriorly, with surrounding confluent T2 hyperintensity. There is an unchanged focus of encephalomalacia in the left caudate nucleus region and areas of encephalomalacia in the bilateral cerebellar hemispheres, but no evidence of acute infarct. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are unchanged.
1. Punctate foci of enhancement in the medial temporal lobe anteriorly may represent hemorrhagic metastasis. 2. Postoperative findings in the left parietal lobe without evidence of recurrent tumor in this area. 3. Chronic left caudate and bilateral cerebellar hemisphere infarcts.