Male, 63 years old, with history of glioblastoma multiforme, status post redo craniotomy for tumor resection. There are postsurgical changes of recent left-sided craniotomy for tumor re-resection in the left temporal lobe. Most of the nodular enhancement surrounding the resection cavity has been resected. Small nodular enhancement is noted along the anterior-inferior and medial aspect of the resection cavity. Focus of enhancement more superiorly involving the left periatrial white matter also remains unchanged.Expected postsurgical changes include pneumocephalus and small extra-axial collection beneath the craniotomy. No significant infarct, large hemorrhage, or new mass effect is appreciated. FLAIR hyperintensity surrounding the resection cavity as well as milder generalized FLAIR hyperintensity involving the bilateral centrum semiovale and corona radiata appears similar. There is mild diffuse sulcal effacement involving the left cerebral hemisphere. No midline shift or herniation. There is ex vacuo dilatation of the left lateral ventricle. No hydrocephalus. Right cerebellar hypoplasia is again noted.
Expected postsurgical changes of redo left-sided craniotomy for tumor reresection. Small residual areas of nodular enhancement are seen along the medial and anterior inferior aspect of the left temporal resection cavity.