Clinical question: History of right vestibular schwannoma status post resection in 2011. Yearly follow-up. Signs and symptoms: Follow-up for tumor. Pre- and post enhanced brain MRI:Dedicated images for evaluation of the IACs demonstrate stable postoperative changes of right-sided suboccipital craniotomy and without evidence of residual or recurrence of tumor. Tiny nodule of enhancement deep in the right internal auditory canal is believed to represent scarring and has remained stable since multiple prior exam.Pre and post enhanced brain MRI demonstrate no diffusion-weighted abnormality.Examination again demonstrates expected postoperative changes of right-sided suboccipital craniectomy evidence of right lateral cerebellar parenchymal volume loss and gliosis without change since multiple prior studies.The anatomical morphology and signal intensity of brain parenchyma is otherwise within normal on all MRI sequences.The signal voids of major intracranial arterial branches are identified.Post contrast images demonstrate no detectable abnormal parenchymal or leptomeningeal enhancement.Unremarkable images through the orbits and including axial fat sat post enhanced series.All paranasal sinuses, bilateral mastoid air cells and middle ear cavities demonstrate normal pneumatization and signal pattern.
1.Stable post operative changes of right suboccipital craniotomy with revisualization of a stable tiny nodule of enhancement in the depth of right IAC since multiple prior exams.2.Pre and postcontrast enhanced brain MRI demonstrate stable right lateral cerebellar encephalomalacia and volume loss and unremarkable otherwise.