82 years Female (DOB:12/27/1933)Reason: metastatic breast cancer with dural based met, s/p RT; please evaluate History: surveillance after RTPROVIDER/ATTENDING NAME: STEVEN J CHMURA STEVEN J CHMURA The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.The dural based plaque-like thickening of the dura adjacent to the upper clivus eccentric to the left side has decreased in thickness from 6 mm to 4 mm. And is decreased from 18 to 15 mm in widthThe marrow signal is heterogeneous with multiple foci of enhancement throughout the calvarium. These foci of enhancement are also present on the prior exam..No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.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. There is redemonstration of a defect along the right lamina papyracea probably related to old orbital medial blowout
1.There is continued regression of a meningeal-based lesion adjacent to the clivus.2.There is redemonstration of extensive osseous metastatic disease.3.No metastatic foci are identified within the brain parenchyma.