Secondary malignant neoplasm of brain [C79.31] / Secondary malignant neoplasm of other parts of nervous system [C79.49], Reason for Study: ^Reason: please perform STROKE PROTOCOL History: L sided weakness Brain MRINew evidence of susceptibility lesions especially around the right frontal lobe where the tumor resection was performed indicate operation related blood products. There is no evidence of acute ischemic lesion on this scan.Metallic artifacts on the right middle cranial fossa due to surgical clips, unchanged. Left occipital approach catheter with left cerebellar FLAIR high signal lesion are again seen, unchanged.Bihemispheric extra axial fluid collections, subdural most likely, are seen and unchanged in terms of distribution and maximum thickness since prior scan. Right precentral gyrus and left middle frontal gyrus FLAIR high signal intensity lesions are seen, unchanged since prior scan.Scattered and somewhat patchy FLAIR high signal intensity lesions on bilateral periventricular white matter and centrum semiovale indicate non specific small vessel ischemic disease, unchanged since prior scan. The ventricles, sulci and cisterns are unremarkable. The paranasal sinuses and mastoid air cells are clear.Brain MRA3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate non visualization of the right ACA, MCA and distal ICA beyond the level of the right ophthalmic artery most likely due to metallic artifacts.The left ICA, MCA and ACA appear to be normal. Vertebrobasilar system appears to be normal. Left PCA appears to be fetal origin.
1. Post right frontal tumor resection status, no unusual finding.2. Unchanged extraaxial fluid collections and multifocal FLAIR abnormalities including left cerebellar lesion since prior scan.3. No evidence of acute ischemic or hemorrhagic lesion.4. Brain MRA is unremarkable.