Past medical history significant for recurrent meningioma status post resection on 4/2/15, hypertension, fibroids, PUD, CAD, and obstructive lung disease who presents with recurrent falls. Left-sided weakness with right-sided visual field deficit. Brain: There are postoperative findings related to recent biparietal craniotomy with scattered pneumocephalus and dural thickening and enhancement. There are mild foci of susceptibility effect in the brain parenchyma surrounding the surgical cavity, which may represent blood products. There are scattered punctate foci and confluent areas of abnormal T2 hyperintensity within the periventricular and subcortical white matter of the bilateral posterior frontal, parietal and occipital lobes, which may represent vasogenic edema, as well as unchanged left parieto-occipital encephalomalacia. There is no convincing evidence of acute infarction. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. There is a partially empty sella. There is persistent right tympanomastoid fluid. MRV: There is lack of signal in the posterior superior sagittal sinus. The other dural venous sinuses are grossly intact.
1. Postoperative findings related to recent partial resection of the posterior falcine meningioma with persistent areas of enhancement diffuse along the surgical margins, which may be treatment-related, although residual tumor cannot be excluded.2. A portion of the posterior superior sagittal sinus has been resected and small amounts of residual tumor may infiltrate the margins of the dural sinus.3. Interval resolution of ischemic changes along the surgical margins without convincing evidence of acute infarction. 4. Persistent bilateral parieto-occipital lobe signal abnormality may represent edema.5. Persistent right tympanomastoid fluid may represent otomastoiditis.