Status post tumor resection. There are postoperative findings related to a right-sided craniotomy for resection of a right parietal lobe mass. There is pneumocephalus and slightly increased small fluid collection with blood products subjacent to the craniotomy site as well as within the resection cavity. There is nodular focus of T1 hyperintensity along the inferior aspect of the resection cavity may represent blood products. No definite evidence of residual tumor is appreciated at this location. There is extensive associated vasogenic edema extending anteriorly into the basal ganglia, medially into the left parietal lobe along the splenium and inferiorly into the right temporal lobe. There is partial effacement of the right lateral ventricle with a 9 mm right to left midline shift, previously measuring 7 mm. There is slight decrease in the prominence of the left lateral ventricle. There is a 5 mm enhancing nodule involving the right occipital lobe. There is a 5 mm enhancing nodule involving the posterior aspect of the left superior frontal gyrus. There is restricted diffusion compatible with infarct involving the right posterior cerebral artery territory including the right occipital lobe and extending into the posterior para hippocampal gyrus. Restricted diffusion is also noted within the right pons consistent with infarct. The capillary gyrus.
1. Postoperative findings related to right-sided craniotomy for right parietal lobe tumor resection. No definite evidence of residual tumor within this location is appreciated. 2. There remains extensive surrounding vasogenic edema with improved right to left midline shift of 9 mm, previously 7 mm. 3. Acute infarct involving the right posterior cerebral artery territory including the right occipital lobe, right posterior aspect of the parahippocampal gyrus, and the right paramedian pons. Finding may have been the result of previously seen uncal herniation.4. 5 mm enhancing nodule in the left frontal lobe involving the posterior aspect of the superior frontal gyrus and a 5 mm enhancing nodule in the right occipital lobe involving the lingual gyrus are consistent with additional metastatic lesions.Dr. Ali discussed findings with Dr.Wallace (NSY) at 1330 hrs on 5/24/2015.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.