Clinical question: h/o ALL s/p chemo and cranial radiation. Small, enhancing extra-axial mass along the right frontal lobe on recent MRI, monitor for changes. Signs and Symptoms: recent onset eye squinting Pre and post enhanced brain MRI:Unremarkable diffusion weighted series.Examination redemonstrate stable mild patchy foci of flair hyperintensity in the periventricular and few in subcortical white matter of cerebral hemispheres without change. Although nonspecific this appearance could represent post treatment/ radiation change.The cortical sulci are mildly prominent for age however less conspicuous since prior study. Mild prominence of the lateral ventricles with maintained midline similar to prior study. There is also prominence of the cerebellar and vermian folia for age without change since prior exam..Post enhanced images demonstrate a small dural based appearing enhancing lesion along the inner table of right paramedian anterior frontal bone without change since prior study. This finding could represent a meningioma. There is no associated parenchymal edema or mass effect which is a similar observation as prior exam. Unremarkable calvarium, orbits and well pneumatized paranasal sinuses/mastoid air cells/middle ear cavities.
1.No acute intracranial findings and no convincing evidence of new finding since prior study.2.Stable mild patchy foci of flair hyperintensity in periventricular and subcortical white matter likely representing post therapy change. 3.Stable small focus of dural based right paramedian inferior frontal enhancement since prior which could represent a meningioma. Further follow up is recommended.4.Prominence of cerebral and cerebellar/vermian folia as mentioned above. 