Altered mental status and cognitive slowing, history of induction chemotherapy for relapsed therapy related AML also with history of ependymoma resection. There is redemonstration of postsurgical changes in the posterior fossa related to suboccipital and right occipital craniotomies for resection of ependymoma with associated ex vacuo dilatation of the fourth ventricle appearing similar to prior. There is no evidence of mass or acute infarct. There are scattered punctate foci of susceptibility artifact which appear grossly similar to the prior exams and which are nonspecific but may reflect treatment effect.The brain parenchyma signal is otherwise within normal limits. There is no pathological intracranial enhancement. Prominence of the cortical sulci and ventricles is compatible with mild parenchymal volume loss greater than expected for patient's stated age, appearing similar to prior. There is no midline shift or herniation. The basal cisterns remain patent. The major cerebral flow voids are intact. There is again mild patchy opacification of the right mastoid air cells. The orbits and scalp soft tissues are grossly unremarkable. Patchy decreased T1 signal within the cervical spine bone marrow is nonspecific but may be related to patient's AML.
1.No acute abnormality or specific evidence of brain tumor recurrence.2.Bone marrow signal abnormality which may be related to patient's AML.