 Note that the examination is limited due to patient movement and the lack of intravenous contrast due to poor renal function.There is a mass involving the left posterior cingulate gyrus and corpus callosum measuring 2.2 x 2.2 cm with susceptibility effect compatible with hemorrhagic component and extensive vasogenic edema. Vasogenic edema extends into the left posterior frontal and temporal lobes. There is significant effacement of the left lateral ventricle and up to 6 mm of rightward midline shift. No uncal herniation. No hydrocephalus. There is also a lesion in the right superior frontal gyrus that measures 7 x 8 mm also with extensive surrounding vasogenic edema. There are additional smaller lesions with mild vasogenic edema in the anteroinferior left temporal lobe and right temporal lobe.Atrophy is again noted in the right cerebellum. Normal flow-voids are demonstrated in the major intracranial vascular structures.
1.Limited examination due to patient motion and absence of intravenous contrast. There are at least four lesions which are seen with extensive surrounding vasogenic edema, the largest of which is in the left posterior cingulate gyrus. These lesions are suspected to represent metastatic disease and biopsy can be considered as clinically warranted.2.Mass effect with up to 6 mm of rightward midline shift. No uncal herniation. No hydrocephalus.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.