Female, 71 years old, with bilateral lower extremity weakness. Evaluate for progression of meningioma, edema. Evaluate for sagittal sinus thrombosis. Redemonstrated is evidence of craniotomy at the parietal vertex. Nonspecific dural thickening and a small fluid collection subjacent to the craniotomy are stable.Tumor centered on the posterior interhemispheric falx in the parietal region is approximately unchanged in size relative to the most recent examination. The most accurate measurements are obtained in the sagittal plane where the tumor measures up to 60 mm in length and 24 mm in thickness, with identical measurements obtained on the prior study.Encephalomalacia and ill-defined T2 signal abnormality affecting the bilateral parietal lobes and the left occipital lobe are unchanged. Scattered additional small foci of T2 hyperintensity within the cerebral hemispheres and brainstem are unchanged. No new lesions are detected. No new pathologic enhancement is seen. No evidence of acute intracranial hemorrhage is observed. The ventricles are stable in size and morphology.On dedicated MRV imaging, no detectable superior sagittal sinus flow or opacification is seen in the vicinity of the tumor and prior resection bed. Anterior and posterior the segment, normal sagittal sinus patency is seen. The size of the sinus defect is similar to that noted on the prior examination. The remainder of the visualized intracranial venous structures are patent.
1.Redemonstration of findings related to prior tumor resection from the parietal vertex.2.Meningioma centered on the parietal interhemispheric falx has not significantly changed in size when compared to the immediate prior examination. Associated encephalomalacia and signal abnormality in the adjacent parenchyma are also unchanged.3.The superior sagittal sinus is absent through the region of tumor and prior resection. Anterior and posterior to this segment, the sagittal sinus demonstrates evidence of normal patency. The size of the absent segment has not changed.