38 year old female with a history of multiple meningiomas. No symptoms. Evaluate for interval change. The patient is status post resection of a right frontal meningioma on 3/17/2015. Compared to previous Brain MRI dated 3/5/2016 the FLAIR hyperintensity/gliosis has decreased and the mild enhancement surrounding the right frontal resection cavity is unchanged. Mild postsurgical dural thickening is also unchanged at the craniotomy site.An enhancing meningioma along the left anterior falx abutting the crista galli measures 0.9 x 0.9 x 1.3 cm (axial series 1001, image 14 and sagittal series 12-3, image 84) and is unchanged compared to the previous exam. There been no interval change in the minimal adjacent edema.There is stable enhancement filling the left Meckel's cave and the right cavernous sinus with extension inferiorly through bilateral foramina ovale with third trigeminal nerves appearing more prominent than expected. These findings are stable.A small enhancing meningioma along the superior aspect of the right tentorium has slightly increased in size, now measuring 0.7 cm (previously 0.6 cm). There is no associated vasogenic edema.There are prominent calcifications of the cord plexus with mild surrounding enhancement which are unchanged. There is grossly symmetric enhancement of the facial nerves, slightly more prominent in the left geniculate ganglion region which is nonspecific. There is also suggestion of enhancement within the distal IACs bilaterally.There is no evidence of intracranial hemorrhage, mass effect, midline shift or herniation. The ventricles and basal cisterns are normal in size and configuration. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
1.Stable postsurgical changes in the right frontal region status post resection of a meningioma. FLAIR hyperintensity/gliosis has decreased and the mild enhancement surrounding the right frontal resection cavity is unchanged.2.Stable small left inferior frontal falx meningioma with mild edema.3.A small enhancing meningioma along the superior aspect of the right tentorium has slightly increased in size4.Stable enhancement filling the left Meckel's cave and the right cavernous sinus with extension inferiorly through bilateral foramina ovale with third trigeminal nerves appearing more prominent than expected. This constellation of imaging features is more suggestive of schwannoma rather than meningioma.5.Stable appearance of the calcified right larger than left choroid plexus with mild surrounding enhancement. Findings are nonspecific, and meningiomas in these regions not excluded.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.