Recent left side pterional craniotomy for debulking and fenestration of craniopharyngioma. There are postoperative findings related to left frontal and parietal craniotomy and more recently left pterional craniotomy with a small amount of hemorrhage deep to the craniotomy flap, in the suprasellar surgical bed and within the occipital horns of the lateral ventricles. There is also mild sulcal effacement in the left frontal lobe perhaps due to edema from retraction. The right frontal and right parietal craniotomy sites are unchanged. The left-sided cystic component of the suprasellar mass has decreased in size. However, the right-sided cystic component and more solid midline component are grossly unchanged compared to the MRI obtained just prior to the surgery. There is persistent mass effect upon the third ventricle. The lateral ventricles appear smaller than in May 2014, but are not significantly changed from the most recent exam. There is mild encephalomalacia in the bilateral anterior frontal lobes. There is no significant midline shift. There is scattered mild mucosal thickening and secretions in the bilateral maxillary and ethmoid sinuses. The orbits are unremarkable. There is an expected degree of left scalp swelling associated with the recent surgery.
1. Recent left pterional craniotomy with a small area of acute infarction in the left basal ganglia and a small amount of scattered postoperative hemorrhage.2. The left-sided cystic component of the suprasellar craniopharyngioma is smaller in size compared with the MRI obtained just before the surgery, while the remainder of the tumor has not significantly changed.3. The lateral ventricles appear smaller than in May 2014, but not significantly changed from the most recent exams.