68 year old male status post tumor resection. Redemonstrated are postoperative changes of a right parietal craniotomy for resection of a mass from the right parieto-occipital region. There is mild ill-defined enhancement along the deep margin of the resection cavity. There is mild diffusion restriction along the resection cavity margins, which likely represents expected post-operative ischemia. There is expected susceptibility within the surgical bed and areas of intrinsic T1 hyperintensity, compatible with postoperative blood products.The overall vasogenic pattern of T2/FLAIR hyperintensity within much of the right cerebral white matter, especially posteriorly, is not significantly changed. The right lateral ventricle is better seen compared to the pre-operative MRI and similar to the more recent post-operative head CT. The 5 mm leftward shift is again seen at the level of the foramen of Monro and not significantly changed. The left lateral ventricle and fourth ventricle are stable and within normal limits.A thin extra axial collection is again seen underlying the craniotomy flap. Other patchy areas of stable mild periventricular and subcortical white matter T2/FLAIR hyperintensity is most consistent with chronic small vessel ischemic disease. There is mild scattered mucosal thickening within right-sided paranasal sinuses.
1.Postoperative changes of a right parieto-occipital craniotomy and resection of underlying mass. There is mild ill-defined enhancement along the deep margin of the resection cavity of which close follow-up is recommended as this may represent residual tumor. 2.There is mild diffusion restriction along the resection cavity relating to post-operative ischemia and central blood products.3.No significant change in the extensive right parieto-occipital vasogenic edema, although with improved mass effect compared to preoperative status. Stable 5-6 mm of leftward midline shift.