History of glioblastoma on treatment with Avastin/TMZ and repeat radiation therapy. Postoperative changes from prior right frontoparietal craniotomy and partial tumor resection. Again seen are areas of heterogeneous enhancement and restricted diffusion in the right frontal lobe, insula, basal ganglia, temporal, and parietal lobes as well as extending into the right aspect of the corpus callosum. This surrounds a stable central cystic cavity. Ill-defined tumor enhancement extends 20 mm anterior to the cystic collection, previously 20 mm. There is associated vasogenic edema as well as mild mass effect in the adjacent right lateral ventricle which is stable. Relative cerebral blood volume generated from perfusion data demonstrates no significant perfusion increase adjacent to the treatment cavity to correspond with areas of enhancement.Numerous scattered small foci of susceptibility predominantly within the right cerebral cortex compatible with posttreatment changes/microhemorrhages. The ventricles and basal cisterns are stable. The expected intracranial vascular flow voids are present. The paranasal sinuses are clear. The visualized mastoid air cells are clear. The orbits are unremarkable.
Stable examination with post treatment changes as described.