Diagnosis: Neoplasm of unspecified behavior of brainClinical question: glioma.Signs and Symptoms: glioma. The patient is status post left parietal craniotomy for removal of a left periventricular neoplasm. There is redemonstration of local loss of volume.There is redemonstration of confluent periventricular white matter signal hyperintensities on T2 and FLAIR MRI which have been progressing over time.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 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.
1.Examination has not changed significantly compared to the prior exam. There is no evidence for local recurrence.2.There is redemonstration and no significant change since the prior exam of periventricular white matter signal changes which are likely treatment related.