Meningiomas, surveillance. Again seen are postoperative changes of prior left parietal craniotomy related to meningioma resection. There is redemonstration of a relatively large area of encephalomalacia in the left superior parietal lobule similar to prior study. There is dural based thickening and enhancement along the posterior falx and along the left posterior parietal convexity which was present previously. The thickening along the posterior falx measures 4 mm, previous 3 mm. The thickening along the left parietal convexity measures 5 to 6 mm in the sagittal plane, previously 4 mm. These are suspicious for en plaque meningiomas and suggest continued close attention on follow-up.Again seen is a meningioma along the high right frontal convexity abutting the superior right frontal sulcus and measures approximately 8 x 8 which is similar to recent study from 11/12/2015 although clearly larger when compared to prior study from 5/8/2010. Slightly more inferiorly along the right frontal convexity is a meningioma measuring approximately 6 x 8 mm previously 5 x 8 mm in the axial plane, measured similarly. There is no evidence of acute intracranial hemorrhage or acute infarction. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. Again noted is prominent enhancement at the left jugular foramen suspicious for meningioma, but not significant changed in the interval. There appears to be extension of tumor proximally into the straight sinus. No significant change in prior.
1. Stable to minimal interval increase in size of two small meningiomas along the right frontal convexity. There is also slight increase in dural thickening along the posterior falx and left parietal convexity suggesting possibility of small en plaque meningiomas in these regions. Suggest continued attention on follow-up. No significant associated mass effect. 2. No significant change in previously described enhancement at the left jugular foramen which is suspicious for meningioma. There is suggestion of tumor extension into the left straight sinus. Consider high resolution CT of the skull base with CTV protocol for confirmation.