Clinical question: History of brain tumor resection. Follow-up 3 months to evaluate for change. Signs and symptoms: None surveillance imaging. Pre and post enhanced brain MRI:No diffusion-weighted abnormalities.Examination demonstrate interval significant decreased size of a dural-based thick enhancement along the left greater wing of the sphenoid at the site of previously resected meningioma. On current exam the remaining enhancement along the left greater wing of the sphenoid has a uniform and very smooth appearance and measuring at 5.3 mm in thickness. Finding is highly suggestive of postoperative change. There is no convincing evidence of residual tumor however further follow-up is recommended.A focus of FLAIR/T2 hyperintensity in the left anterior temporal lobe at the surgical site demonstrate interval evolution to encephalomalacia and with resultant widening of subarachnoid space at this site. Signal intensity of brain parenchyma is otherwise within normal. Ventricular system remain within normal size and with maintain midline.Examination also again demonstrate a thin uniform enhancement along the left frontal and temporal craniotomy site consistent with postoperative change.
1.Negative diffusion weighted series.2.Interval significant decreased thickness on the dural based enhancement along the left greater wing of the sphenoid and likely representing post operative change. Further follow-up is recommended however.3.Encephalomalacia and gliosis in the left anterior temporal lobe at the site of resected tumor.