82 years Female (DOB:1/3/1934)Reason: meningioma growth History: dizzinessPROVIDER/ATTENDING NAME: JAMES R. BRORSON JAMES R. BRORSON The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.There are multiple punctate-sized foci of signal loss on susceptibility weighted imaging located along subcortical white matter predominantly in the right hemisphere. This has not changed significantly compared to the previous exam. In addition there is a punctate focus of signal loss on susceptibility imaging in the left cerebellar hemisphere just lateral to the left dentate nucleus. This is also stable.There is a gyriform linear signal hypointensity on susceptibility imaging along the surface of the brain adjacent to the right precentral sulcus.There is an extra-axial nodule present adjacent to the right postcentral sulcus measuring 7 mm in size with a broad-based the dura which is unchanged in size compared to the prior exam. It is bright on T1-weighted imaging and is associated with susceptibility effect. It is also identified on the CT from 4/9/2014 where it is calcified.No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.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 right vertebral artery appears to be hypoplastic and not readily visualized intracraniallyThe 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. The eyeball lenses are thin.
1.Since the prior exam there does not appear to be any significant change. There is redemonstration of multiple microhemorrhages within the subcortical white matter of the supratentorial brain bilaterally but predominantly in the right hemisphere and also in the left cerebellar hemisphere. This asymmetry is of uncertain significance.2.There appears to be hemosiderin deposition along the left precentral sulcus which was also identified on the prior exam and most likely indicates that prior subarachnoid blood was present at this location.3.Periventricular and subcortical white matter lesions of a mild degree are nonspecific. At this age they are most likely vascular related. 4.There is a stable 7 mm calcified extra-axial lesion present adjacent to the right postcentral sulcus most likely represent a burnt out meningioma.