Clinical question: Left frontal grade 3 oligodendroglioma with 1p19q deletion. Now off all therapy. Signs and symptoms: As above. Pre-and post-enhanced brain MRI:No diffusion weighted findings.Examination demonstrates a focus of hemorrhagic encephalomalacia along the superior aspect of the left mid to posterior frontal lobe consistent with the site of previously treated/operated tumor. There is no evidence of interval change of this finding since prior exam. Post-enhanced images demonstrate no evidence of abnormal enhancement which is a similar observation is prior to study.There is postoperative changes of left frontal -- anterior parietal craniotomy with a small extra axial CSF signal intensity collection confined to the undersurface of craniotomy flap and likely representing an epidural CSF signal intensity postoperative collection. There is expected this enhancement of dura at this level similar to prior exam. There is subtle flattening and deformity of the brain parenchyma at the site of surgery secondary to this collection which may also be as result of adhesion. This appearance remains also identical to prior exam. This collection appears to bulge into the bur hole along the medial edge of craniotomy flap. This is also similar to prior study.Residual flair hyperintensity surrounding the surgical cavity consistent with gliosis is again noted. Unremarkable and stable pre-and post enhanced brain MRI otherwise.
1.Stable post treatment/surgical changes of the left demonstrate oligodendroglioma with out evidence of residual or recurrence of tumor.2.Stable postoperative changes of left frontoparietal craniotomy and extra-axial collection under the craniotomy flap as detailed.3.Unremarkable exam otherwise and without change