Female, 78 years old, status post right frontal craniotomy for tumor resection. Postoperative findings are seen consistent with right frontal craniotomy. Presumed packing material is evident within the frontal sinus and the underlying epidural space. A resection cavity is evident in the paramedian right frontal lobe containing a fluid-heme level. A majority of the previously demonstrated enhancing tumor has been resected. Residual enhancing tissue persists along the posterior cavity margin where it abuts the basal ganglia and ventricular margin.Restricted diffusion is seen surrounding the resection cavity including relatively thick diffusion restriction in the bilateral paramedian frontal lobes and wedgelike restriction in the right caudate head. T2 hyperintensity filling the right frontal lobe extending into the basal ganglia and insula appears similar to the preoperative study. The genu of the corpus callosum remains thickened with abnormal signal extending across midline to the left.Generalized mass effect is slightly improved though the right lateral ventricle remains effaced. Dilatation of the left lateral ventricle has slightly improved. The fourth ventricle is within normal limits. No new enhancing lesions are seen.
Postoperative findings are seen compatible with near complete resection of the enhancing component of a right frontal lobe tumor. A small amount of residual enhancing tumor is suspected along the posterior surgical cavity. Restricted diffusion surrounding the cavity and within the right caudate head is suspected to represent a combination of postoperative cytotoxic edema and ischemic injury. Vasogenic edema in the right frontal lobe is grossly unchanged.