80 years, Female, follow-up meningioma, surveillance. There are postsurgical changes of right frontal craniotomy presumably related to resection of meningioma. There is extensive encephalomalacia in the right anterior and inferior frontal lobes which remains unchanged. Small foci of susceptibility in this region may be related to chronic blood products and/or mineralization. There is a small focal area of thickened, dural based enhancement along the right anterior frontal convexity, measuring up to 4 mm in thickness, which remains unchanged since prior study from 7/16/2011 and compatible with postsurgical change (although minimal residual meningioma is not entirely excluded and can be correlated with extent of surgical resection). No new or enlarging lesions.Otherwise no intracranial mass or mass effect. Minimal scattered nonspecific foci of T2/FLAIR hyperintensity in the white matter are compatible with chronic small vessel ischemic changes. There is global parenchymal volume loss commensurate with patient's advanced age. No evidence of intracranial mass effect, midline shift, or herniation. There is ex vacuo dilatation of the right frontal horn. No hydrocephalus. Remainder of the calvarium and extracranial soft tissues are grossly unremarkable. Bilateral lens implants.
1. Stable postsurgical changes of right frontal meningioma resection. No definite evidence of residual or recurrent meningioma. Please see comment above.2. Known right MCA aneurysm better assessed on recent MRA study.