Renal cell with brain mets, post resection and SRS 7/2014 & whole brain RT 12/2014. There are postoperative findings related to right frontal craniotomy with persistent confluent high T2 signal, but no evidence of abnormal enhancement in the region of the right superior frontal resection cavity. There is interval decrease in size of the enhancing component of the hemorrhagic right parietal lobe lesion and associated vasogenic edema, which now measures 10 mm, previously 17 mm. There is also interval decrease in size of the right occipital lobe hemorrhagic ring-enhancing lesion and associated vasogenic edema, which now measures up to 7 mm, previously 9 mm. In addition, there is interval decrease in size of the enhancing left occipital lobe lesion and associated vasogenic edema, which now measures up to 6 mm, previously 10 mm. Furthermore, there is interval decrease in size of the hemorrhagic enhancing lesion located more laterally in the left occipital lobe lesion and associated vasogenic edema, which now measures up to 5 mm, previously 7 mm. Likewise, the hemorrhagic enhancing lesion in the right precuneus has diminished in size, now measuring up to 2 mm, previously 6 mm. There is an unchanged focus of susceptibility effect in the right superior parietal lobule. There is no evidence of intracranial hemorrhage or acute infarct. There is diminished effacement of the left lateral ventricle posteriorly. There is no midline shift or herniation. The major cerebral flow voids are intact. There is nonspecific fluid signal within the bilateral mastoid air cells, which may represent effusions. There is a right maxillary sinus retention cyst.
Interval decrease in size of the brain metastases and associated vasogenic edema.