Clinical question: History of skull base meningioma with resection. Yearly surveillance. Signs and symptoms: Headache. Nonenhanced brain MRI:Negative diffusion weighted series.Examination demonstrates chronic postoperative changes of right paramedian frontal craniotomy without interval change since prior exam. Under the craniotomy flap there is a focus of CSF signal intensity consistent with postoperative site and with surrounding gliosis. Additional tiny focus of FLAIR hyperintensity in the interhemispheric aspect of left inferior frontal lobe is also again noted without change. Stable tiny focus of encephalomalacia in the right anterior frontal lobe without change.Although examination is performed without the benefit of intravenous contrast there is no gross evidence of recurrence of tumor/meningioma at this site.Stable normal size of the ventricular system with maintained midline.The signal void of major intracranial arterial branches are identified.All paranasal sinuses are visualized and without evidence of disease.Bilateral mastoid air cells and middle ear cavities demonstrate normal pneumatization signal patterns.
1.Stable chronic postoperative changes of right frontal craniotomy for removal of tumor without gross evidence of recurrence on this nonenhanced exam.2.Unremarkable nonenhanced brain MRI otherwise and stable since prior study.