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A sizeable scalp of lesion measuring approximately 5.5 cm in diameter and 2.5 cm in thickness is demonstrated over the vertex, just above the lambdoid suture. The bone and subjacent to the this lesion demonstrates normal fatty marrow, with no evidence of intraosseous extension or erosion. Just to the left of the midline, directly below the mass is a 1 cm bony defect which appears to be filled with arachnoid granulation/and venous lake. No evidence of direct extension through this defect, and within the limitations of MR the outer table above this area appears intact.
The remainder of the brain demonstrates no intra extra-axial collection, mass or region of abnormal enhancement. Diffuse cerebral volume loss is in keeping with advanced patient age, as is degenerative change of the upper cervical spine. Moderate vertebral basilar dolichoectasia is noted.
Conclusion: Extensive scalp lesion does not demonstrate convincing skull or intracranial extension.