 The signal abnormality and parenchymal thickening seen on prior exams within the right thalamus now appears to have normalized on today's exam. The gyral thickening and FLAIR signal abnormality involving the right frontal lobe has nearly completely resolved. The ill-defined signal in the right centrum semiovale which had developed on the prior exam has also nearly completely resolved on today's exam. There is minimal if any residual thickening involving the mesial right temporal, although there may be some persistent insular cortex thickening on the right. However, this is unchanged compared to the previous exam.Postoperative changes are seen from a previous right frontal burr hole and include a punctate stable focus of susceptibility abnormality at the biopsy site within the right thalamus.Postcontrast imaging is significantly limited by motion artifact. Within these limitations there is no evidence of abnormal contrast enhancement.The ventricles and sulci remain mildly prominent but are stable in size and configuration. The cisterns remain patent. There is no midline shift or significant mass effect. There is no diffusion abnormality. No extra-axial fluid collection is identified. Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. Mild mucosal thickening is again seen in the left sphenoid sinus.
Findings compatible with positive response to therapy. The multifocal previously characterized areas of signal abnormality have improved or have become undetectable, particularly the ill-defined signal within the right centrum semiovale which was identified as an area of concern on the prior exam.