Status post tumor resection. Interval postsurgical changes of left parietal craniectomy for resection of metastatic calvarial lesion is seen. Cranioplasty with titanium mesh is noted. There is small focus of T1 hyperintensity and enhancement at the medial margin of the craniectomy defect which was present on prior from 4/6/2015 and nonspecific. No residual tumor within this location is definitively appreciated. Small extra-axial collection is noted at the surgical site with minimal if any mass effect on the adjacent parenchyma. Brain parenchyma demonstrates no evidence of infarct, hemorrhage, mass, or abnormal enhancement to suggest intraparenchymal metastatic disease. There is dural thickening and enhancement along the left parietal convexity which is again seen and may be reactive. Ventricles are within normal limits without evidence of hydrocephalus. Major flow-voids are preserved. Unchanged punctate focus of enhancement in the left frontal calvarium, axial post gadolinium series 15 image 175 of 272.
1. Expected postsurgical changes of left parietal craniectomy and cranioplasty relating to resection of left parietal calvarial mass. No residual tumor within this location is definitively demonstrated. There is small focus of T1 hyperintensity and enhancement adjacent to the medial margin of the craniectomy defect which is nonspecific and can be assessed on follow-up studies.2. Punctate additional focus of enhancement in the left frontal calvarium again seen, which may represent an additional lesion.3. No intraparenchymal metastases is appreciated. Left parietal dural thickening and enhancement is again seen and may be reactive.