55 year old female with fever and old brain mass; evaluate state of intracranial mass There is no evidence of intracranial hemorrhage or edema. No obvious mass or fluid collection is seen on this noncontrast CT. If further evaluation is warranted, MRI or CT with contrast may be obtained.Diffuse areas of hypoattenuation are noted in the periventricular and subcortical white matter, most prominent in the right frontal lobe, which most likely represents gliosis or post-treatment demyelination, versus small vessel ischemic disease of indeterminate age. Presence of vasogenic edema is difficult to be completely excluded in the absence of a prior study for comparison.There is mild asymmetric dilatation of the right lateral ventricle with the remaining ventricles and basal cisterns appearing normal in size and configuration.The calvaria and skull base are radiographically normal. The visualized paranasal sinuses and mastoid air cells are normally pneumatized.
No acute intracranial abnormality or obvious mass is seen on this noncontrast CT. However, this study has limited sensitivity for small intracranial neoplasm or infection. If further evaluation is warranted, MRI or CT with contrast of the brain may be obtained.