 There are postoperative findings related to left parietal craniotomy for resection of a subjacent mass. There is minimally increased T2 hyperintensity inferior to the resection cavity within the deep left frontal white matter that may represent treatment effect or non-enhancing tumor. There is also unchanged adjacent non-specific T2 hyperintensity as well as additional patchy foci throughout the supratentorial white matter. There is unchanged susceptibility effect within the resection cavity as well as an additional unchanged punctate focus of susceptibility effect within the right superior parietal lobule that may resent a radiation induced cavernous malformation or micro-hemorrhage. There is a new focus of enhancement anteromedial to the resection cavity within the left superior frontal gyrus that measures 8 x 17 mm and demonstrates decreased diffusion. There is unchanged thin enhancement along the margins of the resection cavity. Perfusion imaging is not reliable due to poor contrast bolus delivery. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. There is minimal mucosal thickening within the left maxillary sinus.
New enhancement anteromedial to the resection cavity may represent true progression or a treatment effect. This area could be further characterized with MR spectroscopy if clinically indicated.