Clinical question: Evaluate brain tumor resection. Signs and symptoms: Same. Pre- and post enhanced brain MRI:Examination demonstrates postoperative changes of a recent right posterior temporal-parietal craniotomy. There is revisualization of a necrotic thick/irregular rim enhancing tumor at this site measuring at least at 15 x 21 mm in transaxial dimensions compared to prior study measurements of 17.5 x 22.5 mm indicating subtle interval decreased size. Surrounding FLAIR hyperintensity consistent with edema and postoperative changes. There is resultant regional mass effect and without deviation of midline. The surgical path is immediately superior and lateral to the enhancing tumor and extent inferiorly to the trigone of right lateral ventricle. It demonstrates internal mixed-signal intensity and layering consistent with hemorrhage within the cavity. It measures approximately 25 mm in transaxial dimensions and approximately 45 mm in cranial cephalad axis.There is expected postoperative changes of epidural collection of approximately 6 mm thick confined to the inner table of craniotomy flap with subtle mass effect on the adjacent parenchyma. Also noted is 8 mm thick subgaleal collection along the outer table of the craniotomy flap. Expected subtle dural thickening and enhancement in the dysphagia craniotomy is also noted.
1.Examination is status post right posterior temporal-parietal craniotomy with expected postoperative changes as detailed.2.A round necrotic tumor with thick irregular rim enhancing measuring at 15 x 21 mm in size compared to prior study measurement of 17.5 x 22.5 mm.3.The surgical path projects posterior to the tumor and extends inferiorly to the trigone of right lateral ventricle and without detectable continuity with the tumor as detailed/measured above.