Brain:
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Left anterior temporal lobe enhancing mass, 4.7 x 2.7 cm, with cystic components, small foci of intralesional hemorrhage, and markedly elevated blood volume. The lesion extends to the ependymal surface at the left lateral ventricle temporal horn and to the leptomeningeal surface at the medial part of the left sylvian fissure, abutting middle cerebral artery.
Ventricles:
Right frontal external ventricular drain tip in the third ventricle.
Diffuse moderate ventricular dilation.
Blood layering in the occipital horns of the lateral ventricles.
Ependymal enhancement along the left lateral ventricle temporal and occipital horn and strands of intraventricular enhancement in the atrium.
Extra-axial spaces:
Reactive pachymeningeal enhancement over the right frontal convexity.
Arachnoid cyst over the left frontal convexity.
No abnormal leptomeningeal enhancement.
Bone and extra-cranial soft tissues:
Postoperative changes.
Fiducial markers in place in preparation for surgery.
Impression: Left temporal lobe neoplasm with possible CSF dissemination causing hydrocephalus.