Diagnosis: Neoplasm of uncertain behavior of brain, unspecifiedClinical question: Eval for growth of grade II astrocytoma.Signs and Symptoms: grade II astrocytoma s/p surgery and RT.Comments: R frontal grade II astrocytoma s/p surgery and RT. | The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The patient is status post right frontal craniotomy. There is a small focus of T2 and FLAIR signal hyperintensity along the medial aspect of the right superior frontal gyrus associated with volume loss and some distortion suggesting prior surgery.. The appearance is stable since prior exams dating back to 11/8/2012There is a mild to moderate degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images. They're more prevalent along the right hemisphere versus the left.There is a T2 and FLAIR hyperintense punctate lesion along the right posterior pons which is stable compared to previous exams.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.
The exam is stable compared to previous exams. There is redemonstration of a status post right frontal craniotomy for a right superior frontal gyrus lesion as well as periventricular white matter lesions which are presumably treatment related.