Multiplanar multi sequence MR imaging performed with comparison to recent CT brain done the previous MRI.
Extensive confluent T2 hyperintensity involving cerebral periventricular and deep white matter, basal ganglia, internal and external capsules, palmar, and extending through midbrain and pons into the middle cerebellar peduncles and medulla. The changes are almost symmetric, apart from more pronounced left than right thalamic and more pronounced right than left cerebellar peduncle involvement. The overall extent of signal change is similar to previous, possible slight increase in thalamic involvement.
Throughout the regions of signal abnormality there is patchy diffusion restriction. The enhancing focus in the right inferior frontal lobe has reduced in size from 11 x 16 mm to 9 x 12 mm. No new enhancing focus identified.
Right frontal biopsy track contains blood product. Small old lacuna in the left caudate head is again noted. No hydrocephalus.
Conclusion
The right frontal enhancing focus has mildly reduced in size, but extensive cerebral, midbrain, brainstem and deep grey nuclei signal abnormality is similar in extent to previous.