Reason: AA. History: AA. There is redemonstration of postoperative changes of previous left frontal craniotomy for tumor resection, with slight increased posterior extent of T2/FLAIR hyperintensity along the posterior aspect of the left superior frontal gyrus abutting lateral margin of the anterior body the left lateral ventricle. There is progressive ex vacuo dilatation of the left lateral ventricle. Areas of extra-axial enhancement along the surgical bed again are unchanged. Previously seen nodular enhancement along the anterolateral aspect of the resection cavity has further decreased in prominence, essentially imperceptible on the current exam. However, there is an area of ill-defined subtle nodular enhancement which is again seen along the anterior aspect of the resection cavity on 1300/138. This is not significantly changed allowing for differences in technique.The ventricles and sulci are stable. The cisterns remain patent. There is no midline shift or mass effect. There is no diffusion abnormality. No extra-axial fluid collection is identified. Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits.
1. Interval further evolution of postoperative from previous left frontal lobe mass resection. No definite evidence of tumor recurrence or progression.2. Mild further interval increase in T2/FLAIR hyperintensity along the left superior frontal gyrus white matter extending to the left frontal horn may represent post-treatment changes given recent irradiation.3. Previously described nodular enhancement along the anterolateral aspect of the resection cavity is essentially resolved, with a small adjacent area of ill-defined nodular enhancement more anteriorly appearing similar to prior exams. Continued follow-up is recommended.