History of medulloblastoma resected in 1994, with recent seizures, for which workup detected a right parietal meningioma. There is an avidly enhancing right superior parietal convexity extra-axial mass that measures up to 22 mm, which is unchanged. There is associated mass effect upon the underlying brain parenchyma, but no evidence of regional vasogenic edema. There are postoperative findings related to left suboccipital craniotomy with encephalomalacia in the left cerebellar hemisphere, but no evidence of a mass in the posterior fossa. There is diffuse dural thickening related to calcifications. There is encephalomalacia in the right lateral temporal lobe. There are scattered punctate foci of susceptibility effect in the bilateral posterior cerebral hemispheres. There is no evidence of acute intracranial hemorrhage or acute infarct. There is a left transparietal ventricular catheter in unchanged position. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. There is an enhancing mass in the right frontal scalp that measures up to 16 mm. There are bilateral posterior maxillary cystic lesions.
1. Unchanged right parietal convexity meningioma with associated mass effect upon the underlying brain parenchyma, but no evidence of regional vasogenic edema2. Postoperative findings related to left suboccipital craniotomy related to medulloblastoma resection with encephalomalacia in the left cerebellar hemisphere, but no evidence recurrent tumor in the posterior fossa. 3. Diffuse dural calcification may be a manifestation of Gorlin syndrome.4. Bilateral posterior maxillary cystic lesions may represent keratocystic odontogenic tumors, which may also be a manifestation of Gorlin syndrome. Dedicated maxillofacial imaging may provide further insights, nevertheless.5. A persistent right frontal scalp lesion may represent a basal cell nevus or carcinoma or other neoplasm.6. Scattered punctate foci of susceptibility effect in the bilateral posterior cerebral hemispheres may represent cavernous malformations or chronic microhemorrhage related to prior radiation. 7. Unchanged appearance of the shunted ventricular system.