malaise and fatigueClinical question: tumor recurrence, edemaSigns and Symptoms: left sided weakness The patient is status post right-sided parietal craniotomy. There is a cystic lesion with surrounding enhancement and surrounding T2 and FLAIR signal hyperintensity centered in the right parietal lobe and extending into the right posterior temporal lobe which is suspected to represent prior area of tumor resection possibly with some residual recurrent tumor. There is associated susceptibility effect at the margins of the cystic lesion. T2 and FLAIR signal hyperintensity extends into the external capsule and posterior limb of the right internal capsule.There are high signal foci present along the thalami bilaterally and some mild signal hyperintensities in the pons. Signal changes extending down the right cerebral peduncle into the pons is present.There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.A cystic and partially solid mass located in the right parietal lobe and extending into the right posterior temporal lobe is suspected to represent prior area of tumor resection possibly with some residual recurrent tumor, though radiation change status post surgery may have a similar appearance. Please correlate with clinical history. If clinically appropriate, comparison with the prior exams may be of benefit.2.Signal change tracking along the right external peduncle and into the pons is suspected to represent a layering degeneration3.Small lesions in the thalami bilaterally are suspected to represent lacunar infarcts age-indeterminate.4.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related. 5.Examination is somewhat limited by patient motion