Reason: Abnml Brain MRI. Please compare to all the prior studies. Bx revealed no definite evidence of tumor. Please perform MR Perfusion. History: Abnml MRI brain.. Lesion in the left basal ganglia is decreased in size with a decreased extent of T2 signal measuring 2.3 x 1.5 cm (601/17), previously 2.7 x 1.8 cm. There is markedly decreased enhancement with residual enhancement along the lateral margin of the left frontal horn. Intrinsic T1 shortening is similar to the prior exam. Diminished cerebral blood volume within the lesion is again demonstrated. Ex vacuo dilatation of the adjacent left frontal horn has increased suggesting local volume loss. No new enhancing lesions are present.Focus of restricted diffusion in the right mesial temporal lobe has resolved with a punctate residual focus of T2 hyperintensity in this region. There are additional scattered punctate subcortical T2 hyperintensities which are nonspecific and appear similar to the prior exam. A left frontal burr hole is patent with a small amount of encephalomalacia along the biopsy tract.There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
Continued decreased in size and enhancement of left basal ganglia lesion with increased local volume loss. Findings likely represent evolution of an ischemic injury.