Reason: 71 yo M with metastatic thyroid cancer to brain s/p resection and SRS History: bitemporal visual field defect Again seen are postoperative findings related to right occipital craniotomy. Given differences in technique and motion degradation, there is no significant change in mild dural thickening along the posterior falx and right convexity as well as parenchymal enhancement within the right paramedian occipital lobe resection cavity. There is no significant change in confluent T2 hyperintensity along the margins of this resection cavity compatible with gliosis. No new abnormal intracranial enhancement is identified. There is an unchanged background of nonspecific cerebral white matter T2 hyperintensity, which may represent chronic small vessel ischemic disease and/or posttreatment-related changes. Unchanged foci of susceptibility compatible with chronic blood products involving the right occipital and right posterior temporal lobes. No obvious mass involving the orbits, optic chiasm, sella. There is no evidence of acute intracranial hemorrhage or acute cerebral 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. There are bilateral lens implants. Unchanged T1 hyperintense focus in the left frontal calvarium without destructive osseous lesions apparent.
Motion degradation limits sensitivity for small lesions. Compared to 8/10/2015, there is no significant change in posttreatment changes in the right occipital region without evidence of new intracranial metastases.