Lung cancer with history of brain metastases status post SRS. There are multiple subcentimeter supratentorial and infratentorial enhancing lesions. A previously identified ring-enhancing lesion within the right cerebellum measures 0.4 x 0.3 cm, previously 0.6 x 0.5 cm. A ring-enhancing lesion within the left occipital lobe measures 0.4 x 0.3 cm, previously 0.5 x 0.5 cm. There is mild adjacent vasogenic edema. A new left posterior parietal enhancing lesion measures 0.3 x 0.3 cm. There is a new left superior frontal ring-enhancing lesion measuring 0.4 x 0.4 cm. There is new linear T2 hyperintensity along the right occipital lobe, best identified on series 6, image 14, with no associated enhancement. There is subcortical T2 hyperintensity within the posterior right parietal lobe, with no associated enhancement. A T2 hyperintense lesion within the right inferior frontal white matter is unchanged. There is encephalomalacia within the left gyrus rectus. There is also a chronic lacunar infarct in the left basal ganglia with hemosiderin deposition. There is no evidence of acute intracranial hemorrhage or acute infarction. The pituitary gland appears unremarkable. However, there is a subcentimeter enhancing extra-axial lesion along the left jugulum sphenoidale. The ventricles are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits are grossly unremarkable.
1. Multiple subcentimeter supratentorial and infratentorial metastases. The lesions within the right cerebellum and left occipital lobes are decreased in size. However, at least two enhancing lesions within the left cerebral hemisphere appear to be new.2. A subcentimeter enhancing lesion along the left jugulum sphenoidale may represent a metastasis or meningioma.3. Encephalomalacia of the left gyrus rectus and new scattered areas of T2 hyperintensity, which are perhaps treatment related.