51 years, Male, status post craniotomy for tumor resection. Compared to MRI dated 4/19/2016, there are interval postsurgical changes of left temporoparietal craniotomy for partial resection of the previously seen area of enhancement surrounding the prior resection cavity. There remains residual areas of heterogeneous enhancement in the left temporal lobe extending to the ependymal surface of the left lateral ventricle. There is minimal rind of restricted diffusion along the resection cavity margin compatible with cytotoxic edema. Extent of T2/FLAIR hyperintensity involving the left temporal, parietal, and occipital lobes is similar to prior. Ventricular system is not significantly changed in size, without evidence of hydrocephalus. No significant midline shift or uncal herniation. Expected postsurgical changes include blood products in the posterior temporal resection cavity, minimal extra-axial fluid, as well as fluid collection in the left scalp. Evidence of prior endoscopic sinonasal surgery again noted as well as partial paranasal sinus opacification, primarily including the bilateral frontal and bilateral anterior ethmoid air cells.
Expected postsurgical changes of craniotomy for repeat GBM resection. There has been partial resection of the previously seen area of heterogeneous enhancement in the left temporal lobe, which may represent combination of recurrent tumor and posttreatment change.