60 year-old male status post heart transplant, with altered mental status Examination demonstrates ill-defined hypoattenuation change in the tip of right temporal lobe in associated with a coarse calcification mass. The mass appears wrapping around the greater wing of sphenoid on the right side. It shows no significant change when compared to previous MRI study. Patchy area of low attenuation change is identified in the left frontal lobe with associated prominence of the sulci, consistent with encephalomalacia. There is no new density change in the remainder parenchyma. No evidence of hemorrhage or midline shift is detected. Cortical sulci, ventricular system and all CSF cisterns are symmetric and mild prominent secondary to parenchymal volume loss. Calvarium and skull base is negative for metastatic disease. The visualized paranasal sinuses and mastoid air cells are unremarkable.
1. Right temporal tip coarse calcification mass with associated vasogenic edema. Differential diagnosis includes slow growing meningioma, calcified metastatic lesion. The finding is stable when compared to previous MR study.2. Left frontal lobe encephalomalacia. There is no evidence of acute intra-or extra-axial hemorrhage.