Lung cancer with brain metastases status post treatment. There is interval decrease in size of the numerous supratentorial and infratentorial ring-enhancing lesions, many of which contain susceptibility effect suggestive of chronic hemorrhage. For example, a right precentral gyrus lesion measures up to 12 mm, previously 16 mm and a left posterior midbrain lesion measures up to 8 mm, previously 11 mm. The vasogenic edema associated with the lesions has also diminished. There are unchanged multiple enhancing lesions in the skull, the largest of which measure up to approximately 10 mm. There is no evidence of acute infarct. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift. There are unchanged mildly low-lying cerebellar tonsils. The major cerebral flow voids are intact. The orbits are grossly unremarkable. There is a small left maxillary sinus retention cyst. There is an unchanged nonspecific punctate nodule in the left frontal scalp. There is mild mucosal thickening and/or fluid within the right mastoid air cells.
1. Interval decrease in size of the numerous intracranial metastases and associated vasogenic edema.2. Unchanged skull metastases.3. Unchanged mildly low-lying cerebellar tonsils.