Left cerebellopontine angle epidermoid: dizziness and nystagmus. There are postoperative findings related to left suboccipital cranioplasty with diffuse encephalomalacia in the left cerebellar hemisphere. There is a non-enhancing T2 hyperintense lesion with relatively low diffusivity in the left cerebellopontine angle cistern that measures 14 x 19 mm, previously 12 x 17 mm. There is mild mass effect upon the brainstem. There is no midline shift or herniation. There are a few scattered foci of T2 hyperintensity in the cerebral white matter, which may represent chronic small vessel ischemic disease. There is no evidence of acute infarction or hemorrhage. The major cerebral flow voids are intact. The left facial, vestibulocochlear, and trigeminal nerves are not well-delineated. There is extensive atrophy of the left masticator and facial expression muscles due to denervation. There is a persistent fluid collection superficial to the cranioplasty mesh that measures up to 20 mm in thickness. There is an enhancing subcentimeter right temporal scalp nodule.
1. Postoperative findings in the left posterior fossa with slight interval increase in size of the epidermoid centered in the left cerebellopontine angle cistern. 2. Persistent pseudomeningocele overlying the left cranioplasty site.3. Nonspecific enhancing subcentimeter right temporal scalp nodule. 