History of prostate cancer. Evaluate for metastases. CT of brain with infusion:Examination demonstrates no evidence of metastatic disease to the brain. Finding consistent with minimal small vessel disease of indeterminate age are noted. Extensive postoperative changes of left frontal craniotomy is again identified with interval improvement since prior exam. Area of low attenuation in the left frontal lobe inferiorly in the pattern of vasogenic edema is again identified and is believed to represent an area of encephalomalacia on the current exam. This area has decreased in extent since prior study. There is no evidence of mass effect as was noted on the prior exam and no midline shift is noted. Extensive postoperative changes along the floor of the left anterior cranial fossa including bony grafts and extensive sclerotic changes of the floor of the left anterior cranial fossa remains stable. Postoperative changes along the left lamina papyracea with surrounding soft tissue thickening with associated mass effect on the left medial rectus muscle appears similar to prior study. This area should be further evaluated with dedicated CT or MRI of orbit/ maxillofacial region with infusion.There is better pneumatization of the left maxillary sinus and left ethmoid air cells and left maxillary sinus since prior examination.This examination was performed without any added contrast for this study however patient received contrast for CT of abdomen and this exam was performed immediately after CT of abdomen.
1.No evidence of metastatic disease to the brain or leptomeninges.2.Extensive postoperative changes at the level of the floor of the left anterior cranial fossa, left orbit and left ethmoid air cells with no definitive appendectomy she will interval change. This area can be reevaluated with dedicated the studies.