Clinical question:Evaluate status post tumor resection. Signs and symptoms: Brain tumor resection. Pre-and post-enhanced head CT:There is chronic postoperative changes of a right posterior temporal parietal craniotomy with underlying focus of parenchymal low attenuation representing surgical cavity. Tiny air bubble within the surgical cavity is noted. There is no detectable enhancement and no appreciable mass-effect.There is a large focus of vasogenic pattern of low-attenuation in the left posterior temporal and extensively extending into the left parietal lobe. Residual postsurgical air and small patchy foci of hemorrhage within the surgical cavity at the site is noted. There is no convincing evidence of abnormal enhancement to suggest residual tumor. This however needs to be confirmed with an MRI examination of brain. Postoperative changes of a recent left craniotomy evident by residual pneumocephalus and expected overlapping soft tissues of the scalp thickening is noted. Changes on the left results in mass effect on the left lateral ventricle and with trace midline shift to the right.
1.Postoperative changes of left parietal -- posterior temporal craniotomy without convincing evidence of residual tumor. Follow-up with an MRI exam is recommended for better assessment.2.Postoperative changes of right posterior temporal craniotomy without convincing evidence of abnormal enhancement.3.Extensive residual edema and postop changes in the left hemisphere results in mass effect on the left lateral ventricle and trace midline shift to the right.