Pineal tumor resection. There are interval postoperative findings related to partial resection of a pineal tumor via a posterior approach. There is pineal tumor, particularly along the inferior aspect of the resection cavity, which measures up to 32 mm and protrudes into the left thalamus. There is an area of restricted diffusion along the medial aspect of the right thalamus. There is a small amount of hemorrhage and gas within the ventricular system. There is encephalomalacia and superimposed edema in the right occipital lobe, with adjacent extra-axial fluid, blood products, and hemostatic agent along the surgical approach. The ventricles are not significantly changed in size, with a right transfrontal ventricular catheter in position. There are unchanged scattered nonspecific foci of T2 hyperintensity in the cerebral white matter. There is an enhancing 20 mm diameter left occipital subcutaneous nodule. There is a small amount of fluid within the maxillary sinuses.
1. Interval subtotal resection of a pineal mass associated with a small amount of intraventricular and regional extra-axial hemorrhage, as well as acute ischemia in the right thalamus.2. No significant change in size of the shunted ventricular system.3. Nonspecific enhancing 20 mm diameter left occipital subcutaneous nodule. 