Rule out metastasis. Headache. Known neoplastic process. There is a right frontoparietal extra axial hyperdense lesion again identified, measuring two x 5 0.1-cm [image 17]. It is adjacent to the right craniotomy defect, very similar in appearance when compared to prior MRI 5/13/2009. Large amount encephalomalacia involving the right frontal lobe is again seen with ex vacuo dilatation of the right lateral ventricle. There are calcifications seen within the displaced falx, as well as the periphery of this extra-axial lesion. There is no other evidence of intracranial hemorrhage. Left frontal encephalomalacia again seen. Left lateral ventricle is moderately dilated. The basal cisterns are patent. Mild vascular calcifications. Diffuse thickening , with lucent and sclerotic appearance of the right lower frontal temporal calvarium as well as the sphenoid bones and are identified, underlying metastasis cannot be excluded.
No acute intracranial abnormalities. Again identified is a large right extra-axial frontal parietal hyperdense collection, similar in appearance when compared to prior MRI 5/13/2009. 