Clinical question : Status post craniotomy for removal of a seizure focus. Now with seizures. Signs and symptoms: Possible. Nonenhanced head CT:Examination the most postoperative changes of a large right frontal /temporal craniotomy. Epidural fluid -- air collection under the craniotomy flap is present. This finding is within the expected postop changes. There is evidence of partial right anterior temporal lobectomy with residual air and minimal postoperative hemorrhage. There is a area of low-attenuation in the inferior aspect of right frontal lobe and to a lesser degree of the left frontal lobe consistent with areas of encephalomalacia as was noted on prior MRI examination from 3 -- 24 -- 11.Superior to the surgical site focal area of edema is noted in the right frontal lobe. Residual small amount of subarachnoid blood within the cortical sulci of bilateral cerebral hemispheres are noted. A thin CSF density right parafalcine subdural measures approximately 2 mm in thickness. Prominent bilateral basal ganglial calcification and left frontal periventricular calcification is noted.
1.Expected postoperative changes of a large right frontal and temporal craniotomy.2.Small area of edema lungs immediately superior to the surgical site which may be postop change.3.Residual subarachnoid blood from surgery both in supero-and infratentorial spaces.4.Extensive bilateral basal ganglial calcification.5.Extensive inferior bifrontal encephalomalacia unchanged since prior studies. 