History of brain metastasis. Status post craniotomy. Examination demonstrates postoperative change of the left parietal craniotomy, including blood products at the surgical site of the left posterior parietal lobe and left frontal pneumocephalus. Surrounding the surgical site, there is diffuse edema. There is a redemonstration periventricular small vessel ischemic disease. No other hemorrhage, midline shift or abnormal extra-axial fluid collection is identified. The ventricles and sulci appear prominent but symmetric. There is effacement of the left occipital horn.The previously MRI identified masses are not visualized on the present non-infused exam.The visualized paranasal sinuses and mastoid air cells are normally pneumatized.
Expected postoperative changes of the left parietal craniotomy including blood products at the surgical site and pneumocephalus. Small vessel ischemic disease of indeterminate age.