Clinical question: History of meningioma. Status post surgery and cyber knife for recurrence. Signs and symptoms: Surveillance scan. Pre-and post-enhanced brain MRI:Examination demonstrate bone marrow signal placement (T1 isointense and T2 hypointense) and thickening of the right skull base and including the right occipital condyle with uniform enhancement similar to prior exams.Additionally there is an associated extra osseous focus of enhancement in the right inferior cerebellopontine angle cistern which abuts the right foramen of Luschka similar to prior exam. This focus of enhancement is within the surgical bed at the level of previously resected meningioma. It measures approximately 10 x 20 mm in transaxial dimensions on axial post enhanced series 11 x 23. There is no significant interval change in the size or the extent of this finding since prior study. Similar to prior exam this focus of enhancement abuts the right lateral aspect of medulla however without detectable signal abnormality to suggest presence of edema.Examination redemonstrates a single punctate focus of flair hyperintensity in the subcortical white matter of right frontal lobe which is a nonspecific finding. Unremarkable and stable pre-and post enhanced brain MRI otherwise.
1.No evidence of an acute or new finding since prior exam.2.Marrow signal replacement and uniform enhancement of right skull base including right occipital condyle similar to prior exam.3.Associated with above finding is a right inferior cerebellopontine angle extra-axial enhancement measuring approximately 11 x 23-mm without convincing evidence of change since prior study.4.Similar to prior exam the above mentioned enhancement is inseparable from the right lateral aspect of the medulla and right foramen of Luschka as detailed.