Status post craniotomy for tumor resection. Assess tumor. Non-infused CT of brain:Extensive postoperative changes of right frontal craniotomy for removal of tumor. A small area of hemorrhage along the most medial aspect of the surgical cavity is a new finding since prior exam. This finding is best appreciated on axial image 12. The hemorrhage measures approximately 7 mm times 8-mm in transaxial dimension. Additional small patchy areas of high density material along the dorsal aspect of the surgical cavity are also believed to represent hemorrhage. I suspect possible minimal increase in these areas of hemorrhage as well. The foci of hemorrhage along the dorsal aspect of the surgical cavity are very small and slice positioning differences between the two studies may contribute to the difference in their appearance. There is interval absorption of air within the epidural space under the craniotomy flap since prior study. Epidural thickening along the inner table of bony flap is within the expected range of postop change.The brain parenchyma immediately posterior to the surgical cavity demonstrates subtle low attenuation this is also new finding since prior exam. I recommend further follow-up with an MRI examination to evaluate for residual/recurrence. Mass-effect and midline shift has improved since prior study. No significant midline shift is detected and ventricular system remains stable.
1.Subtle small areas of new hemorrhage in the most medial aspect of the surgical cavity.2.New low-attenuation of brain parenchyma surrounding the surgical cavity is concerning for new vasogenic edema or ischemic change.3.Follow-up with an infused MRI examination is recommended.4.Improvement in postoperative changes of right frontal craniotomy.