45 years Male (DOB:2/16/1971)Reason: GBM post crani History: GBM post craniPROVIDER/ATTENDING NAME: EDWIN RAMOS EDWIN RAMOS Since the prior exam the patient has undergone right-sided craniotomy. There is a catheter entering the craniotomy site with tip in the larger and more laterally oriented cystic cavity of the mass lesion. Since the prior exam this tumoral cystic cavity has decreased in axial dimensions from 48 x 33 mm axial dimensions 2 38 x 12 mm axial dimensions. There is associated scalp soft tissue swelling. The left lateral ventricle is mildly dilated. There is mild subfalcine herniation present.There is no change in the appearance of the other cystic cavities within the tumor bed. One in the region of the left centrum semiovale measures 19 x 16 mm and previously measured the same. Another cystic cavity in the right thalamus measures 12 x 17 mm and has also not changed. One at the right cerebral peduncle and right internal capsule measures 14 x 12 mm and is also unchanged. The patient's right deep gray nuclei mass remains and is associated vasogenic edema which was also present on the prior exam. There are multiple punctate foci of signal hypointensity within the mass.The third ventricle is shifted towards the left by 9mm. This has decreased from 11mm.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
Since prior exam the patient has undergone placement of a drainage catheter into a left-sided tumoral cystic cavity. The particular cystic cavity has decreased in size and there is now slightly less mass effect. There is some mild subfalcine herniation present. The rest of the tumor mass and associated vasogenic edema remain stable.