POD#2 after right orbitofrontal craniotomy for tumor resection. Aphasic immediately post-op, EEG negative. There are postoperative findings related to right anterior cranial fossa extra-axial tumor resection via subfrontal osteotomy with removal of the anterior wall of the right frontal sinus with a small amount of nodular dural enhancement along the floor of the resection cavity. There is a diffuse thin rim of susceptibility effect and apparent restricted diffusion along the margins of the surgical cavity in the right orbitofrontal gyri, as well as a confluent area of high T2 signal in the right frontal lobe white matter. There is scattered high FLAIR signal in the cerebral sulci. There are scattered nonspecific foci of high T2 signal in the cerebral white matter. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The right frontal sinus and frontoethmoid recess have been obliterated. There is subgaleal fluid in the frontal region that measures up to 12 mm in width. There are secretions and mucosal thickening in the left maxillary and sphenoid sinuses.
Postoperative findings related to right subfrontal osteotomy with probable small amounts of residual meningioma, residual edema surrounding the resection cavity, persistent scattered foci of subarachnoid hemorrhage, and a subgaleal fluid in the frontal region that measures up to 12 mm in width, but no evidence of territorial infarction.