64 years Female (DOB:9/26/1951)Reason: s/p SRS for metastasis surveillance eval History: s/p SRS for metastasis surveillance evalPROVIDER/ATTENDING NAME: STEVEN J CHMURA STEVEN J CHMURA There is a new enhancing nodule measuring 5 mm in size located along the left postcentral gyrus laterally.Previously noted punctate lesions along the left superior frontal gyrus are not readily identified on the current exam.There is an 11 x 19 mm axial dimension lesion adjacent and anterior aspects of the squamous portion of the left temporal bone which is associated with contrast enhancement and diffusion restriction. This was not present on the priorThere is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.Punctate focus of signal loss is present in the left external capsule on susceptibility imagingNormal 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 demonstrate partial opacification of the right mastoid air cells. The visualized portions of the orbits are intact.
1.A new lesion is present along the left postcentral gyrus which is suspicious for metastatic disease.2.There is a mass adjacent to the outer surface of the left squamous portion of the temporal bone which is new since prior exam. The possibility that this represents metastatic focus cannot be excluded. It is associated with adjacent thickening of the galea.3.Previously noted lesions along the left superior frontal gyrus are no longer appreciated