71 years Male (DOB:9/27/1944)Reason: Pt with hx of brain metastasis; parkinsonism, tremor History: see abovePROVIDER/ATTENDING NAME: TAO XIE TAO XIE The patient status post right parietal lobe surgery and right-sided craniotomy. There is a CSF cavity within the brain parenchyma at the surgical site no abnormal enhancing focus is identified at the surgical site. There is surrounding T2 and FLAIR signal hyperintensity. Compared to prior exam there is no significant change in the appearance of the surgical site. There is susceptibility effect at the surgical margins Normal 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.There is a mild degree of punctate foci of signal loss and susceptibility in the periventricular white matterThere is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.Status post right parietal lobe surgery. There is no evidence for tumor recurrence on the current exam.2.Periventricular and subcortical white matter lesions of a mild degree are nonspecific. At this age they are most likely vascular related. 3.Some periventricular and to lesser subcortical microhemorrhages are present which are nonspecific.