Signs and Symptoms: brain lesionComments: Pre op MRI. Surgery today. Please page resident to place fiducials. 6876 | The CSF spaces are appropriate for the patient's stated age with no midline shift. There is redemonstration of a ring-enhancing lesion in the left inferior parietal lobule measuring 8 mm , ring-enhancing nodule in the right inferior temporal gyrus measuring 8 x 4 mm and 7 x 6 mm enhancing nodule located along the isthmus of the cingulate gyrus.There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images. Additional T2 and FLAIR hyperintense lesions are present along the internal capsules and brainstem 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.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.There are multiple ring-enhancing lesions present within the brain parenchyma. Differential considerations include metastases as well as abscesses.2.Periventricular and subcortical white matter as well as the brainstem changes of a mild degree are nonspecific. At this age they are most likely vascular related. 3.Examination was performed the purpose of stereotactic guidance during surgery.