Neoplasm of uncertain behavior of brain, unspecified [D43.2], Reason for Study: ^Reason: Post op R crani for tumor resection History: lethargy Post-resection status of the right globus pallidus mass lesion with right frontal approach ventriculostomy tube insertion status.There are susceptibility artifacts within the resection cavity, surrounding bran parenchyme as well as intraventricular space especially on the left lateral ventricle occipital horn indicating operation related blood products.On Gad enhanced scan, there is minimal enhancements especially on the posterolateral aspect of the original mass which may indicate residual tumor. Comparing to pre-operative scan, the degree of midline shift has been significantly improved.And ventricle size also has been decreased likely due to ventriculostomy tube insertion.The extent of surrounding edema on the right frontal lobe appears to be slightly decreased, but grossly no change since prior scan.Other enhancing intra axial lesion on the left temporal lobe does not show any interval change since prior scan in terms of size, enhancement pattern and the extent of surrounding edema,There is no evidence of new acute ischemic or hemorrhagic lesion on this scan.There is about 10.1mm (RL) x 18.1mm (AP) x 20.8mm (CC) sized peripherally enhancing lesion with some central stippled enhancement within the left temporalis muscle associated with temporalis fascial enhancement indicating most likely inflammatory lesion, clinical correlation and follow up scan can be considered.Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.
1. Post resection status of the right globus pallidus lesion with right frontal approach ventriculostomy insertion status.2. Blood products within the resection cavity, surrounding brain parenchyme and left lateral ventricle indicate postoperative changes.3. Interval improvement of midline shift, interval decrease of ventricle size and slightly decreased the extent of surrounding edema of the right globus pallidus lesion.4. No change of the left temporal intra axial enhancing lesion.5. No evidence of new acute ischemic or hemorrhagic lesion.6. Left temporal extracranial enhancing soft tissue lesion involving both temporalis muscle and overlying fascia suggesting inflammatory in nature. Clinical correlation and follow up imaging may need to be considered. 