Clinical question: Evaluate tumor resection. Signs and symptoms: Evaluate tumor resection. Pre and post enhanced brain MRI:Examination is status post a large right temporal and frontal craniotomy. There is a large extra-axial right convexity serosanguineous subdural collection along the large right craniotomy site. Finding results in mass effect on the right temporal and frontal lobes. In the right anterior frontal the extra-axial collection measures at 14 mm in thickness, in the right posterior temporal collection measures at 12 mm in thickness and in high convexity right posterior frontal-parietal this collection measures approximately 14 mm in thickness. Since prior exam there is interval decrease postprocedural air within this collection. Compared to prior head CT from 7-7-15 there is no significant change in the overall mass effect and 15 mm the radiation of midline to the left is identical to prior study. Mild dilatation of left lateral ventricle also remains stable since prior exam.Post enhanced images demonstrate interval partial resection of right-sided extra-axial mass from the right anterior and mid temporal region. Extensive residual tumor still present. The mass in the basal cistern and with extensive encasement of right carotid artery, bilateral cavernous sinuses, right cerebellopontine angle, right skull base and right posterior temporal thickening noted. Extensive surrounding vasogenic edema demonstrate no convincing evidence of change.
1.Examination is status post large right temporal and frontal craniotomy with extra-axial serosanguineous/air subdural collection as detailed/measured above.2.There is partial resection of a large extra-axial mass from the right anterior and mid temporal region since prior exam.3.Extensive residual tumor in the basal cistern, right orbital apex, sella, sphenoid sinus, bilateral cavernous sinuses (R>L), central and rightward skull base, extensively in the right cerebellopontine angle as detailed above. There is a visualization of extensive encasement and decreased caliber of right supraclinoid internal carotid.4.Mass effect from residual tumor and edema and postop changes of the right hemisphere results in approximately 15 mm leftward deviation of midline similar to prior study and with stable mildly dilated left lateral ventricle.