Diagnosis: Secondary malignant neoplasm of brainClinical question: h/o metastatic melanoma s/p resection of left frontal and SRS to left frontal and right cerebellar lesionsSigns and Symptoms: surveillance post SRS The patient is status post left-sided craniotomy. There is a small extra-axial collection present at the craniotomy defect which was also previously present and appears thinner on the current exam versus the prior. A lesion located in the left middle frontal gyrus on the prior exam is not significantly smaller. It currently measures approximately 7 x 9 mm axial dimensions and previously measured approximately 17 x 17 mm axial dimensions. The amount of adjacent T2 signal hyperintensity is also regressed. There is some associated susceptibility effect.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.Since the prior exam a left middle frontal gyrus hemorrhagic lesion has decreased in size.2.Status post left-sided frontal craniotomy with associated evolving postoperative change.