Right craniotomy for resection of a large pituitary adenoma on 3/30/2015 Limited study due to patient inability to cooperate.Redemonstration of right frontal temporal craniotomy. There is swelling and fluid in the extracranial soft tissue. There is also small amount of extra-axial fluid and blood subjacent to the craniotomy. There is trace midline shift to the left with effacement of the right lateral ventricle. There are areas of parenchymal T2 hyperintensity of the right anterior temporal lobe, right inferior frontal lobe, right insula, right caudate head, and left basal ganglia. As seen on prior MRI, right caudate head and left basal ganglia show diffusion restriction suggestive of ischemia. Other areas may represent edema or ischemia. Mega cisterna magna again noted.Debulking of a large sellar/suprasellar tumor with residual tumor seen predominant at the right superior aspect of the suprasellar cistern. The residual tumor extends towards the third ventricle with continued mass effect on the third ventricle. There is track/stalk-like area of enhancement from this tissue to the deformed sella, which may be residual tumor or pituitary infundibulum. Residual tumor is also seen extending into the prepontine cistern. There is blood product in the operative bed. Bilateral ICA flow-voids are present.
1.Postoperative findings of partial resection of the sellar and suprasellar tumor.2.Areas of parenchymal abnormality of the right anterior temporal lobe, right inferior frontal lobe, right insula, right caudate head, and left basal ganglia. As seen on prior MRI, right caudate head and left basal ganglia show diffusion restriction suggestive of ischemia. Other areas may represent edema or ischemia.