Clinical question: History of meningioma status post resection; also with history of multiple sclerosis. Signs and symptoms: Surveillance scan for meningioma. Pre and post enhanced brain MRI:Unremarkable diffusion weighted series.Examination demonstrate stable postoperative changes of a left frontal and temporal craniotomy without evidence residual or recurrence of tumor/meningioma. Expected subtle dural thickening and enhancement along the inner table of craniotomy flap is again noted.Extensive periventricular and to lesser degree subcortical and corpus callosum foci of flair hyperintensity consistent with patient's diagnosis of multiple sclerosis is again identified. There is no evidence of any appreciable interval change since prior study and without evidence of an enhancing plaque. There is revisualization of a small left anterior frontal development of venous anomaly without evidence of an associated cavernoma.Mildly prominent supratentorial ventricular system and with maintained midline remains similar to prior exam.The signal void of major intracranial arterial branches are identified.The intracranial venous sinuses demonstrate normal signal intensity and with normal pattern of enhancement.Unremarkable images through the orbits, paranasal sinuses and mastoid air cells.
1.No evidence of acute or new finding since prior study. 2.Stable postoperative changes of the left frontal and temporal craniotomy without evidence of residual or recurrence of tumor/meningioma.3.Extensive findings of demyelinating disease without significant change since prior exam or detectable enhancing plaque.