59 years, Female, status post tumor resection. There are postsurgical changes of craniotomy for resection of large right parietal meningioma. Blood products are seen involving the resection bed. There is evidence of near total resection with residual enhancing tissue noted surrounding the superior sagittal sinus. There is rim of restricted diffusion surrounding the resection cavity much of which is related to blood products with small amount of cytotoxic edema. There is mild enhancement involving the right parietal lobe along the anterior-inferior aspect of the resection cavity with restricted diffusion and compatible with cytotoxic edema/postsurgical change. There is also vasogenic edema involving the right parietal lobe which is mildly increased. There is mild downward mass effect at the level of the resection cavity and minimal leftward midline shift.There is small filling defect involving the superior sagittal sinus which was not present on prior MRI with corresponding hyperdensity seen on recent CT likely representing a small thrombus. Superior sagittal sinus posterior to the level of the residual meningioma is widely patent.No hydrocephalus. Major arterial flow-voids are preserved. Paranasal sinuses and mastoid air cells are clear. Prominent mineralization of the basal ganglia is again noted.
1. Postsurgical changes of large right parietal meningioma resection. There is near total resection with minimal residual tumor surrounding the superior sagittal sinus.2. Faint enhancement in the right parietal lobe anterior inferior to the resection cavity with restricted diffusion is consistent with small amount of cytotoxic edema/postsurgical change.3. Small filling defect involving the superior sagittal sinus which was not present on preoperative MRI from 7/20/2015 and with corresponding hyperdensity on recent CT is consistent with a small thrombus. Superior sagittal sinus posterior to the level of the residual meningioma and the remainder of the major dural venous sinuses are patent.