 There are postoperative changes of left temporal craniotomy including skin staples and a subgaleal hematoma. There is heterogeneous T1 and T2 signal, fluid fluid levels and susceptibility artifact within and adjacent to the left temporal lobe corresponding to the heterogeneous density seen on the prior CT. And adjacent extra-axial collection measures up to 10 mm in thickness (series 7, image 16) and extends anteriorly and superiorly along the frontal lobe and falx. Foci of hypointensity within the extra-axial collection are compatible with gas bubbles. Heterogeneous signal within the left temporal lobe measures 29 x 17 mm, slightly increased in size compared to the CT. A 13 mm area of gyriform diffusion restriction and FLAIR abnormality is seen adjacent/posterior to the collection. The ventricles and sulci are within normal limits. The basal cisterns remain patent, particularly the suprasellar cistern on the left is now normal in appearance. There is no midline shift. Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits.
Status post left temporal lobe surgery with postoperative changes including temporal lobe blood products and extra-axial collection. Findings suggestive of cytotoxic edema in the left temporal lobe adjacent to the surgical site may be related to acute infarction.