Clinical question: Patient with known glioblastoma, on Avestin, now with speech difficulties, right-sided weakness. Rule out bleed. Signs and symptoms: Same Unenhanced head CT:Examination demonstrates no evidence of acute intracranial hemorrhage.Extensive low-attenuation of white matter of the left cerebral hemisphere and to a lesser degree of the right hemisphere is consistent with posttreatment changes as well as residual edema/encephalomalacia of patient's known tumor. There is no appreciable change when compared to prior MR. There is an irregularly shaped calcification of the proximal left frontal lobe at the site of previously noted susceptibility signals are prior MR. Dilated supratentorial ventricular system are essentially similar to prior study. There is no evidence of midline shift. Recommend further follow-up with an MRI exam.
1.No evidence of acute intracranial hemorrhage as clinically questioned.2.When compared with prior MRI constellation of intracranial findings of brain tumor, post therapy changes, ventriculomegaly remains essentially similar.3.Recommend follow-up with an MRI.