26 years Male (DOB:3/26/1990)Reason: hx of brain tumor s/p resection p/w HA, dizziness; eval for tumor recurrence, increased ICP History: HA, dizzinessPROVIDER/ATTENDING NAME: MURRAY J KEENE DAVID HOWES The patient status post right parietal craniotomy for removal of a right parietal lobe neoplasm. There is encephalomalacia involving the right parietal lobe and the right cuneus as well as a small portion of the right lingual gyrus associated with ex vacuo effect on the right lateral ventricle. There is a couple punctate foci of signal loss at the area of encephalomalacia. Some nodular enhancement is present at the surgical site. These are unchanged compared to the previous examThere is nodular enhancement present within the right internal auditory canal measuring 6 x 5 mm axial dimensions which previously measured similar dimensions. There are small foci of signal loss and susceptibility imaging in the lateral ventricles especially along the frontal horns as well as in the fourth ventricleThere are several punctate foci of signal loss and susceptibility in the subcortical white matter of the left cingulate gyrus and left parietal lobe.Ventriculostomy tube courses through the right parietal lobe into the trigone of the right lateral ventricle and has its tip in the temporal horn of the right lateral ventricle. Its tip is embedded into the right hippocampus. As a punctate focus of susceptibility effect at the tip of the ventriculostomy tube in the right hippocampus.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrate mucous retention cyst in the maxillary sinuses. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.Status post right parietal lobe surgery. There is encephalomalacia centered in the right parietal lobe. The appearance of the surgical bed is stable compared to prior exams2.Ventriculostomy tube is present in the right lateral ventricle. Its tip is located in the right hippocampus. The lateral ventricles are stable.3.Stable right internal auditory canal lesion suspicious for schwannoma.