Prolactinoma status post craniotomy 3 months ago and cabergoline therapy subsequently. The images are partly degraded by dental brace artifact. There are postoperative findings related to transcranial resection of a pituitary tumor. There is now herniation of the optic apparatus and portions of the bilateral inferior frontal lobes into the expanded sella, where the heterogeneously enhancing residual pituitary tumor with extension into the left cavernous sinus has decreased in size, measuring up to 12 mm in thickness, previously 36 mm. The pituitary stalk appears to be intact. However, there are surrounding linear bands of tissue. There has been interval removal of the bilateral transfrontal approach biventricular drains. The third and lateral ventricles have decreased in size from the prior examination. There is encephalomalacia in the right frontal lobe and body of the corpus callosum, likely related to the surgical approach. There is no evidence of acute infarction, within the limits of artifact.
1. Postoperative findings related to resection of a pituitary tumor, now with herniation of the optic apparatus and portions of the bilateral inferior frontal lobes into the expanded sella, where there has been marked interval decrease in size of the treated tumor, with what may represent surrounding granulation tissue and adhesions. 2. The triventricular system is less dilated than before.