 Again seen is a ill-defined homogenously enhancing mass involving the right middle cranial fossa that extends into the right orbital apex, sella, suprasellar cistern, prepontine cistern, right Meckel's cave and cavernous sinus, and consistent with known meningioma. Mass measures approximately up to 45 mm in the AP and transverse dimensions and not significantly changed. Craniocaudal extension is also not significantly changed. There is right-sided proptosis similar to prior. Although the lesion encases the right ICA, the vessel remains patent. There appears to be some extension of the tumor into the left cavernous sinus, stable compared to prior examination. Tiny 8 x 3 mm focus of extra-axial enhancement adjacent to the left transverse sinus is also is unchanged and compatible with an additional meningioma.Again seen is evidence of right frontotemporal craniotomy with encephalomalacia involving the right anterior temporal and frontal lobes. Confluent and patchy T2/FLAIR hyperintensity compatible with moderate chronic small vessel ischemic disease and treatment changes is unchanged. No evidence of acute infarct or new mass or mass effect. Major flow-voids are preserved. Atrophic changes are again noted involving the right muscles of mastication which may be related to denervation.
1.No significant interval change of meningioma involving the right middle cranial fossa which extends into the right orbital apex, sella, suprasellar cistern, Meckel's cave, and right greater than left cavernous sinuses.2.Postsurgical and post-radiation changes appear unchanged.