64-year-old male, evaluation of exposed hardware, left orbit, history of meningioma status post resection 2003 There are postsurgical changes of left anterior frontotemporal craniotomy with underlying encephalomalacia involving the anterior inferior frontal lobe and anterior temporal lobe presumably related to resection of prior meningioma. There is thickening of the left zygoma and left sphenoid wing which may be related to prior surgery and radiation, although this could represent residual hyperostosis as well. There may be some enhancement and thickening of the cutaneous tissues lateral to the left orbit which is nonspecific; inhomogeneous fat suppression could also account for these findings. There are no fluid collections or findings to suggest osteomyelitis. The surgical hardware is better assessed on recent CT study.There is no intraparenchymal restricted diffusion to suggest acute ischemia. There is no evidence of intraparenchymal hemorrhage. There are no extra-axial collections. There are no discrete intraparenchymal masses. There is no mass effect.There is scattered periventricular and subcortical T2/FLAIR hyperintense foci compatible with chronic small vessel ischemic disease.The left maxillary sinus is completely opacified with what may represent secretions or a large mucous retention cyst. There is near complete opacification of the left sphenoid sinus as well. The mastoid air cells and middle ear cavities are unremarkable. There are normal flow voids within the intracranial carotid and vertebral vasculature.
1. Postoperative changes of left anterior frontotemporal meningioma resection with encephalomalacia at the resection cavity.2. There maybe some cutaneous enhancement and thickening lateral to the left orbit which is nonspecific. Inhomogeneous fat suppression could also account for the findings. There are no fluid collections or findings to suggest osteomyelitis. 