29 years, Female, status post left frontal craniotomy with pathology confirmed meningioma. First surgery August 2009, with reoperation October 2013. Status post proton therapy completed February 2014. Patient is status post left frontotemporal craniotomy, with unchanged localized encephalomalacia within the left inferior frontal gyrus. There is increase enhancement within the overlying bone flap and underlying dural layer at the craniotomy site extending along the orbital ridge, measuring 3.0 x 1.7 cm (series 1101, image 83; series 1201, image 7), previously 2.4 x 2.1 cm. There is an unchanged T2 hyperintense fluid collection within the left middle cranial fossa, compatible with an arachnoid cyst. There is no restricted diffusion to suggest acute ischemia. No intracranial hemorrhage is identified. The ventricles are within normal limits in size and configuration. Major flow-voids are preserved.Sella and orbits are grossly within normal limits.
1.Status post left frontotemporal craniotomy with increased enhancement within the overlying bone especially inner table side and underlying dural layer at the craniotomy site and extending along the left orbital ridge, which is suspicious for local recurrence versus post treatment related revascularization and resorption of bone flap.2.Unchanged localized inflammation within the left inferior frontal gyrus.