Status post brain tumor resection. Assess extent of resection. There are expected changes related to the recent resection on the left temporal mass. Accounting for T1 hyperintensity along the surgical margin, which probably reflects the presence of blood products, there is a small area of contrast enhancement along the anterior-inferior-lateral surgical margin. Even smaller foci of contrast enhancement are present along the lateral aspect of the superior surgical margin. These may represent residual tumor tissue but may also reflect early post resection enhancement. Contrast enhancement along the posterior-superior surgical margin, which abuts the temporal horn of the left lateral ventricle, is likely reactive enhancement in the choroid plexus. There is hemorrhage in the anterior inferior lateral aspect of the left temporal lobe anterior to the surgical, likely within the anterior aspect of the fusiform gyrus. There is minimal volume of blood products in the occipital horn of the left lateral ventricle. The T2-hyperintensity surrounding the left temporal treatment bed is not significantly changed. While midline shift is slightly improved, now 4 mm compared to 6 mm at the level of the lower aspect of the septum pellucidum, impingement on the suprasellar cistern has slightly increased. There is no sign of perioperative infarct. There continues to be no other focus of brain enhancement. Noncontrast enhancing, non-diffusion-restricted foci of T2-hyperintensity in the cerebral white-matter probably reflect chronic microvascular ischemia. Major intracranial vascular flow voids are preserved, reflecting gross patency.The relatively large right nasopharyngeal mucosa retention cyst is unchanged. Focal T2-hyperintensity in the posterior aspect of the right masseter cells is unchanged and nonspecific.
1.The left temporal mass has been resected. Small foci of contrast enhancement along the surgical margin, especially along the anterior-inferior-lateral surgical margin, may reflect residual tumor or may reflect early post surgical contrast enhancement. Follow-up MRI imaging may better characterize the significance of these foci of contrast enhancement. 2.There is small hemorrhage extending from the anterior-inferior surgical margin into the anterior aspect of the left fusiform gyrus. There is also minimal hemorrhage in the occipital horn of the left lateral ventricle.