Evaluate for change in mass, edema. Posterior fossa meningioma which worsening drowsiness and headaches. No evidence of intracranial bleed. Again seen is a left-sided posterior fossa lesion exerting mass effect upon the left cerebellar hemisphere with effacement of the extra-axial space and fissure. It is not as well bowel weighted on the noncontrast CT as in recent contrast-enhanced brain MRI. No hydrocephalus. There is minimal mass effect upon the fourth ventricle. The supratentorial compartment demonstrates stable appearance with no evidence of intracranial bleed, stable mild to moderate diffuse bilateral periventricular and subcortical white matter hypodensities.
No interval change in the appearance of the head CT when compared to 12/31 2008. The evaluation of the posterior fossa meningioma is not well achieved by this noncontrast CT alone. A more adequate/accurate evaluation can be achieved with an MRI of the brain with contrast, if clinically indicated. There is no evidence of intracranial bleed or hydrocephalus.