67-year-old female with history of right cerebellar pontine angle meningioma status post cyber knife and resection. Limited exam secondary to lack of IV contrast.Postsurgical changes from a right sided suboccipital craniotomy and CP angle tumor resection are seen. There is significantly reduced T2/flair hyperintensity in the right cerebellum, right middle cerebral peduncle, and right aspect of the pons. Additionally, there is reduced effacement of the fourth ventricle. There is slightly increased right cerebellar encephalomalacia with associated increased extra-axial fluid adjacent to the right cerebellar hemisphere, likely postsurgical. Small area of susceptibility within the surgical bed likely represent chronic blood product. There are scattered punctate foci of T2/flair hyperintensity in the periventricular and subcortical white matter. No acute ischemia is seen. The visualized paranasal sinuses and mastoid air cells are clear. The orbits are unremarkable.
1.Limited exam secondary to lack of IV contrast which decreases sensitivity for the detection of recurrence.2.Postsurgical changes of right CP angle meningioma resection with evidence of decreased local edema.3.No definitive evidence of bulky tumor recurrence without the benefit of IV contrast. If warranted, the patient may return to obtain just the post contrast imaging to complete her evaluation.4.Nonspecific T2/flair hyperintensity in the periventricular and subcortical white matter is likely secondary to chronic ischemic small vessel disease.