55 years Male (DOB:6/5/1961)Reason: Re-evaluate disease status following additional therapy; History: compare to previous scan and provide bi-dimensional measurements per RECIST 1.1PROVIDER/ATTENDING NAME: JASON JOHN LUKE JASON JOHN LUKE On susceptibility imaging there are multiple subcortical punctate foci of signal loss present in both hemispheres. Additionally there are punctate foci of signal loss in the basal ganglia and left internal capsule as well as subcortical white matter of the cerebellar hemispheres bilaterally. Many of these lesions can also be seen on the T2 and FLAIR images. In particular one located in the right caudate nucleus has evolved and is relatively stable compared to the 3/4/2016 exam.The patient is status post right-sided parietal craniotomy. There is encephalomalacia present along the right inferior parietal lobule extending to the right temporal lobe associated with susceptibility effect.There is redemonstration of diffuse periventricular and subcortical white matter confluent signal changes which were also present on the previous exams to a similar extent.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells demonstrate opacities in the right mastoid air cells. The visualized portions of the orbits are intact.
1.There are multiple hemorrhagic type lesions scattered throughout the brain which appear relatively stable compared to the exam from March. The patient is known to have metastatic melanoma to the brain.2.Extensive and diffuse white matter signal changes have been present on prior exams and are most likely treatment related.