Seizure. ?Previous tumor resection. There is an anterior, interhemispheric resection bed that is CSF-filled. There is increased T2 signal, volume loss and parenchymal distortion involving the adjacent anteromedial aspect of the frontal lobes. There is an overlying bifrontal craniotomy. Frontal sinuses are opacified which may reflect postsurgical change and/or secretions. Smooth dural enhancement is present which is likely postsurgical. No suspicious nodular nodular enhancement is seen.Multiple foci of susceptibility are seen involving the bilateral cerebellar hemispheres compatible with chronic microhemorrhages. The remainder of the brain is notable for mild volume loss. No evidence of intracranial mass or mass effect. There is ex vacuo dilatation involving the bilateral frontal horns. No hydrocephalus. The major intracranial flow voids are patent (including the anterior cerebral arteries).Mastoid air cells are clear. Two well-circumscribed, T2 hyperintense lesions involving the maxillary alveolar ridge are probably related to the periodontal cysts but not well assessed.
1.Postsurgical changes of bifrontal craniotomy with resection cavity and gliosis involving the bilateral anterior inferior frontal lobes. There is smooth dural enhancement consistent with postsurgical change. No findings to suggest recurrent tumor.2.Multiple small foci of susceptibility involving the cerebellum are compatible with chronic microhemorrhages.3.No evidence of acute infarct, intracranial mass, or mass effect.4.Opacified bilateral frontal sinuses are at least in part related to postsurgical change with areas of T2 hyperintensity reflecting obstructed secretions or possibly CSF.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.