Clinical question: Evaluate change in meningioma. Signs and symptoms: None surveillance scan. Pre and post enhanced brain MRI: Negative diffusion weighted series.Examination demonstrates a well demarcated and uniformly enhancing extra-axial mass in the right paramedian inferior frontal abutting the floor of the anterior cranial fossa at the level of right olfactory groove. This finding results in mass effect and deviation of the frontal lobe without associated vasogenic edema. The size, morphology, pattern of enhancement and extent of this lesion remains identical to prior exam. There is no evidence of extracranial extent of tumor which is a similar observation is prior study. This mass measures maximum of 17 x 29 x 16.5 mm.Similar to prior exam there are a few punctate foci of FLAIR hyperintensity in the periventricular and subcortical white matter as well as minimally of bilateral basal ganglia and lung noticeably in bilateral thalami (right greater than left) without evidence of hemorrhage or enhancement and highly suggestive of chronic small vessel ischemic strokes.Unremarkable images through the orbits, paranasal sinuses and mastoid air cells.
1.No acute intracranial process.2.Stable meningioma in the right olfactory groove in size (17 x 29 x 16.5 mm), morphology, pattern of enhancement and extent.3.Mild chronic small vessel ischemic strokes in the subcortical, periventricular white matter and bilateral basal ganglia/thalami.