Male, 21 years old, with headaches and history of cervical GBM, evaluate for intracranial lesions. Postoperative changes are partially visualized on sagittal images related to laminectomy of the upper cervical levels and biopsy of the patient's known spinal cord tumor. On comparison with the preoperative examination, there appears to be more conspicuous enhancement within the lesion. Also of note, there is a fluid collection within the laminectomy bed which measures up to 46 mm in sagittal length and 11 mm in thickness.Intracranially, dural thickening and mild prominence of the extra-axial spaces is seen along the frontal lobes. Mild generalized sulcal vascular prominence is also noted. No evidence of parenchymal edema or mass effect is seen. No diffusion restricting lesions are demonstrated. No evidence of any pathologic intra-axial enhancement is seen. The ventricles and basal cisterns remain normal in size and morphology.
Postoperative findings are seen reflecting prior cervical laminectomy and spinal cord lesion biopsy. The degree of enhancement within the cord lesion appears to have increased, though it is incompletely assessed on this examination. There are no findings to suggest any intracranial tumor involvement at this time.A fluid collection is present within the cervical laminectomy bed which follows CSF signal characteristics and which is suspicious for a pseudomeningocele. Intracranial findings including dural thickening, slight widening of the extra-axial spaces, and sulcal vascular prominence may reflect changes in intracranial pressure related to this potential CSF leak. 