Male, 19 years old, status post re-resection of a cerebellar ganglioglioma, with swelling and drainage at the incision site. Again seen are findings related to right occipital craniotomy for tumor resection. A small epidural fluid collection beneath the craniotomy site is similar to or at most slightly increased from the prior examination. However, an extracranial fluid collection which appears to follow CSF signal has developed within the soft tissues of the neck overlying the craniotomy and extending inferiorly in the neck fascial planes to the C3 level. The collection measures up to 78 mm in craniocaudal extent, and measures 62 x 25 mm in maximal transaxial dimension.Lack of contrast limits assessment for residual tumor. However, the degree of T2 hyperintensity and restricted diffusion surrounding the cerebellar resection site has improved. The right cerebellum remains smaller than the left likely reflecting the effects of prior surgery and/or treatment. The quantity of postoperative intracranial air and intraventricular blood have also decreased. No new parenchymal lesions are seen. Again noted is prominence of the CSF space involving the right aspect of the pineal cistern. The supratentorial ventricular system is normal and similar in caliber to the prior exam.
1.Demonstration of postoperative findings compatible with recent re-resection of a cerebellar ganglioglioma. Lack of contrast prevents accurate assessment for residual tumor.2.Since the prior examination, an extracranial fluid collection has developed at the operative site compatible with a pseudomeningocele.