Clinical question: Evaluate for change in meningioma. Signs and symptoms: Meningioma, subcutaneous lesion. Pre-and post enhanced brain MRI:No diffusion weighted abnormality.Examination redemonstrates a stable dural based extra axial meningioma in the left posterior frontal region. It measures approximately 26.5 mm at the base and 17-mm cranial cephalad axis which has remained stable since prior study. It results in subtle indentation of the adjacent parenchyma without detectable signal abnormality.A shallow dural broad-based extra axial enhancing mass in the left pterion is again identified and without change. Finding is consistent with an additional tiny meningioma measuring at 12-mm at the base and 7-mm in height.Additional tiny focus of T2 hyperintensity in the right frontal high convexity with several rim enhancement similar to prior study. The finding could represent a heavy calcified meningioma without change and measuring approximately 6.4 mm in size.The scattered periventricular and subcortical foci of flair hyperintensity without appreciable change since prior exam and likely are presenting mild chronic small vessel ischemic strokes.Unremarkable cortical sulci, ventricular system and the CSF spaces. No detectable abnormal parenchymal or meningeal enhancement.Stable nonspecific isointense enhancing mass in the subcutaneous right occipital region without change and measuring at 19 x 13.5-mm.
1.No acute or new intracranial findings since prior exam.2.Stable meningioma in the left frontal, left pterion and high convexity right frontal as detailed/measured above.3.Findings suggestive of mild chronic small vessel ischemic strokes without significant change.4.Nonspecific well-demarcated uniformly enhancing mass in the right occipital subcutaneous region without change.