Brainstem glioma: increased dysarthria and ataxia. There is no appreciable change in the heterogeneous upper brainstem mass, measuring up to approximately 23 mm, with a small cystic area along the right aspect of the mass. The mass protrudes into the inferior portion of the third ventricle and there is unchanged mild prominence of the bilateral lateral ventricles. There are unchanged punctate foci of susceptibility effect in the brainstem and surrounding areas, which may be related to prior radiation therapy. There is unchanged encephalomalacia in the medial right cerebellar hemisphere. There is also a punctate focus of encephalomalacia at the site of the previously demonstrated acute right external capsule infarct. There is an unchanged small cystic area in the left basal ganglia, which may represent a chronic lacunar infarct or prominent perivascular space. There are unchanged mild nonspecific scattered areas of high T2 signal in the periventricular white matter. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
1. No appreciable change in the treated brainstem glioma.2. Unchanged encephalomalacia in the medial right cerebellar hemisphere. 3. Chronic right external capsule lacunar infarct. 