follow up meningioma resection. Previously shown left high fronto-parietal extra axial mass has been removed near totally. Subtle non enhancing area just underneath of the craniotomy site adjacent to the prior tumor location is most likely localized brain with swelling. Superior aspects of sinus invasion portion of the tumor have also been removed significantly. In particular bilateral dural leaflets of superior sagittal sinus as well as superior aspect of the superior sagittal sinus appear to be much less tumor burden than prior exam. Intra-sinus extension of the tumor also appears to be removed significantly.On coronal post enhanced scan, there were some non enhancing lesions mainly attached to the left side dural leaflet may suggest remained tumor.Significant parenchymal edema which compresses left lateral ventricle is again shown. The extent and degree of the mass effects do not show any significant interval change since prior exam (Jan 12 2015 Stealth MRI).There is no evidence of acute ischemic or hemorrhagic lesion.There is no evidence of new unusual enhancement or engorged venous structure comparing to prior exam.The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.
1. Post operative status of the left high frontal and parietal meningioma with extensive parenchymal edema and superior sagittal sinus invasion.2. Near total removal of main tumor as well as sinus invasion portion as described above. Small residual mass is suspected especially intra-sinus portion of the tumor.3. There is no evidence new parenchymal edema or hemorrhagic lesion postoperatively.