NSCLC with brain metastases status post SRS. There has been interval increase in size and number of intracranial metastases. For example, the posterior left fusiform gyrus lesion measures up to 6 mm, previously 3 mm. In addition, there are approximately seven new scattered supratentorial and infratentorial enhancing lesions with mild associated vasogenic edema. For example, a lesion in the region of the left flocculus measures up to 11 mm, a lesion along the left posterior cingulate sulcus measures up to 5 mm, and a lesion in the right superior frontal gyrus measures up to 3 mm. There is no evidence of acute infarct. There are subcentimeter foci of encephalomalacia in the bilateral thalami and adjacent to the left frontal horn of the lateral ventricle. There is also an unchanged background of nonspecific cerebral white matter T2 hyperintensity. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues appear unchanged.
1. Interval increase in size and number of intracranial metastases.2. Chronic lacunar infarcts and probable chronic small vessel ischemic disease.