 There is mild worsening of cystic and solid mass in the suprasellar cistern extending into the prepontine, cerebellopontine angle cistern, right ambient and right quadrigeminal cisterns as well as the right middle cranial fossa.1.New nonenhancing cystic mass in the right suprasellar region extending along the anterior cranial fossa skull base and superiorly into the right inferior frontal lobe measuring 15 x 14 mm in oblique axial dimensions (series 501 image 15), and 16 mm CC (series 1201 image 5). 2.Mildly increased irregular nodular enhancement with concomitant increased cystic portion in the suprasellar cistern3.Slightly increased right ambient cistern cystic lesion measures 13 mm in short axis (series 601 image 15) compared to 10 mm previously. 4.Minimally increased left perimesencephalic cistern cystic mass measures 13 mm in short axis (series 601 image 17) compared to 12 mm previously. This lesion also shows mild new intrinsic T1 shortening suggesting interval bleeding or proteinaceous debris. There is slight increased craniocaudal dimension of the adjacent right ventral perimesencephalic cistern component now measuring 12 mm CC.There is persistent mass effect on the brainstem which is slightly worsened in the right ambient cistern and regional to the right inferior frontal lobe due to presence of new/worsening lesions as described above. There is persistent mass effect on the optic chiasm with superior elevation, and the right carotid terminus with superior elevation as noted before.The ventricles are not significantly changed in size and configuration. There is no acute infarct, midline shift or herniation. There are postoperative findings related to right temporal craniotomy with stable cavity in the right anterior temporal lobe, and a right transfrontal catheter terminating in the right prepontine cistern without significant change. Punctate nonspecific foci of T2 hyperintensity within the frontal lobes are unchanged and left occipital lobe. There is persistent left cerebellar volume loss.There is trace mucosal thickening in the right maxillary sinus with aerated secretions centrally. There right maxillary sinus appears somewhat diminutive in size.
Mild interval worsening of the mass with new cystic component in the right anterior cranial fossa, as well as mild interval worsening of few cystic components as described above, with minimally increased mass effect at the right inferior frontal lobe and the right midbrain. The remainder of the mass is overall similar in size with similar mass effect. Please see details above.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.