 Examination is motion degraded. Again seen is enhancing mass in the sella extending superiorly and filling the suprasellar cistern measuring up to 30 mm in the craniocaudal dimension and 20 mm in the AP dimension, sagittal series 11 image 14, which is not significantly changed. Transverse dimension of approximately 24 mm, measured at the level of the optic nerves, is also not significantly changed. Encasement of the optic chiasm is again seen. The mass also appears to involve the bilateral A1 segments which are not well identified. There is increased T2/FLAIR hyperintensity along the optic tracts as well as in the left inferior frontal lobe as before which may reflect edema and/or gliosis.Extra-axial mass consistent with meningioma along the right greater sphenoid wing is also again seen and measures approximately 15 mm in the short axis, similar to prior. In the craniocaudal dimension, this lesion measures up to 34 mm, previously 31 mm, sagittal series 11 image 22.Additional meningioma in the posterior fossa along the inferior aspect of the tentorium narrows the right transverse sinus as before. This lesion measures 16 x 24 mm, which is not significantly changed. There is susceptibility effect within this lesion likely reflecting calcification.Left frontal craniotomy changes are again seen. Stable small area of encephalomalacia in the left frontal lobe is again seen. There is no diffusion abnormality to suspect acute stroke. The ventricles and sulci are normal. No intra-axial masses are identified. Normal flow-voids are demonstrated from major intracranial arteries.
1.Compared to 8/14/2013, there is no significant change in meningioma involving the sella and suprasellar cistern.2.Stable to minimal interval increase size of right sphenoid wing meningioma.3. No significant change in meningioma in the posterior fossa along the tentorium.