Reason: Preop planning for 6/27 surgery. Study patient. Craniotomy for tumor History: none- preop Limited exam for surgical planning purposes was obtained. There is redemonstration of postoperative changes from previous right temporal parietal craniotomy, with a stable cystic-appearing resection cavity in the right posterior temporal region. There is persistent irregular enhancement along the posterior margin of the cavity, with redemonstration of T1 hypointense and T2 hyperintense discrete oval satellite lesions surrounding the resection cavity. The overall size of these cystic lesions is not significantly changed, although with slight increased convexity of the margins of the most superior lesion which now measures 13 x 15 mm. A thin extra axial collection underlying the craniotomy flap persists, measuring 7 mm in greatest thickness with mild mass effect.There is a similar pattern of confluent T2 hyperintensity within the surrounding right posterior cerebral white matter, including extension to the right internal and external capsules posteriorly. Abnormal T2 hyperintensity is also seen in the splenium of the corpus callosum. There is stable age-related volume loss diffusely, with a small area of linear T2 hyperintensity within the right frontal subcortical and deep white matter.
1.Redemonstration of multiple peripherally enhancing lesions surrounding the right posterior temporal resection cavity margins, as previously described, with slight increased convexity of the margins of the most superior lesion.2.Similar extent of T2 abnormality within the surrounding white matter which is nonspecific and may represent accommodation of post treatment changes, vasogenic edema, and/or nonenhancing tumor.