Female, 82 years old, with history of parafalcine meningioma status post fractionated radiotherapy. A T2 heterogeneous, T1 isointense tumor nodule is seen along the anterior interhemispheric falx just above the cingulate gyrus. The lesion is bilateral but predominantly right sided. Since the prior examination, there has been perhaps a slight decrease in lesion size as it now measures 17 x 15 mm in the axial plane, previously 19 x 16 mm. The lesion abuts the adjacent frontal lobe parenchyma but causes no edema or mass effect.Patchy periventricular white matter T2 hyperintensity is again seen, a finding which likely reflects chronic microvascular ischemic disease. No evidence of parenchymal edema, mass effect or restricted diffusion is seen. No acute intracranial hemorrhage or any abnormal extra-axial fluid collections are observed. The ventricles and sulci are prominent compatible with parenchymal volume loss.
The treated anterior parafalcine tumor is perhaps slightly smaller than on the prior examination. No new intracranial lesions are detected.