History of glioblastoma multiforme. Follow-up exam. Redemonstrated postoperative changes from left parietal tumor resection. There is a residual 7 mm thickness subdural collection with high T1 and high T2 signal compatible with hematoma.The centrally necrotic rim-enhancing mass in the left parietal lobe is increased in both overall size as well as thickness of the enhancing rim when compared to prior. While the irregular morphology somewhat limits comparison measurements, the area of enhancement now measures 5.3 x 4.2 cm in maximum axial dimension, previously 3.5 x 3.8 cm.The central cystic resection cavity has decreased in size. There is been marked interval increase in vasogenic edema involving the left parietal and frontal lobes. This partially effaces the left lateral ventricle and results in approximately 5 mm rightward midline shift. The basal cisterns are preserved and there is no evidence of uncal herniation. The expected intracranial vascular flow voids are present. Scattered minimal opacification of the paranasal sinuses. The visualized mastoid air cells are clear. The orbits are unremarkable.
1. Redemonstrated centrally necrotic peripherally enhancing tumor mass in the left parietal lobe. There has been interval increase in lesion size, thickness of the enhancing rim, and associated vasogenic edema. There is now partial effacement of the left lateral ventricle as well as 5 mm rightward midline shift.2. Stable extra-axial collection overlying the left parietal lobe measuring 7 mm in thickness compatible with resolving hematoma.