A large extra-dural mass, bulging into the right middle cranial fossa mass is again demonstrated which likely arises from the right cavernous sinus and Meckel's cave extending inferiorly to surround the right ICA along it segments from C3 to C5 and protrudes into the posterior fossa through the right petroclinoid ligament, involving the trigeminal nerve and bulging the anterolateral aspect of the pons. It is well circumscribed, and has a heterogeneous signal: predominately low on T1, but with some peripheral bright areas, bright on T2 followed by FLAIR suppression, and demonstrating peripheral thin rim of contrast enhancement, representing dura. The lesion shows very bright DWI signal with intermediate ADC (720 x 10-6 mm2/s) and has no elevated relative cerebral blood volume (rCBV). Spectroscopy trace shows a hypometabolic trace. No significant changes were observed compared to the previous exams, considered the limitations of assessing digitized films.
The lesion seems just to compress and displace the adjacent temporal lobe, with no signs of adjacent oedema.
The remainder brain is unremarkable.