Clinical question: Evaluate for growth of grade ll oligoastrocytoma on TMZ. Signs and symptoms: Grade ll oligoastrocytoma. Pre and post enhanced brain MRI:Examination redemonstrates extensive FLAIR and T2 hyperintensity in the left hemisphere most apparent in the left parietal region. Findings involves the cortex and extensively of the subcortical and periventricular white matter with resultant parenchymal volume loss and ex vacuo dilatation of the left lateral ventricle. Findings are consistent with previously surgical rise and treated left hemispheric tumor without significant change. There is no detectable abnormal enhancement of the brain parenchyma or the leptomeninges which is also a similar observation as prior study.Patchy and confluent right hemispheric white matter FLAIR hyperintensity similar to prior exam and representing post treatment changes and likely related to overlapping changes of chronic small vessel ischemic strokes. The midline is maintained and the CSF cisterns remain patent.Chronic expected postoperative changes of left parietal craniotomy similar to prior exam is again noted.
Stable post surgical/treatment changes of left hemispheric oligoastrocytoma without evidence of new finding to suggest recurrence of disease.