Clinical question: Evaluate for change in mass. Signs and symptoms: Near syncope. Nonenhanced head CT:In comparison with prior examination there is further interval increase in the size of the right temporal horn and trigone of right lateral ventricle.There is interval improvement of postoperative changes and including complete absorption of air from surgical site. Diffuse area of low attenuation of white matter in the right posterior temporal and parietal lobe is grossly similar to prior exam. There is also overall less mass-effect and decrease in the midline shift. The midline shift at the level of the septum pellucidum on the current exam measures 6.4-mm wide on the prior exam measured 11.2. Recommend further follow-up with an MRI for better evaluation of residual tumor. There is a small linear increased density in the right parafalcine location adjacent to the surgical cavity which may represent small amount of blood. Possibly tumor calcification at the surgical site cannot be entirely ruled out. The only available exam is from 12 -- 23 -- 10 and there are no more recent exams for comparison.
1.Interval increase in the size of right temporal horn believed to represent entrapped right temporal horn.2.Interval improvement in postop changes.3.Overall there is less mass-effect on the current exam than prior study however 6.4-mm midline shift to the left at the level of septum pellucidum is still present.4.Diffuse area of low attenuation in the right posterior temporal, occipital and parietal likely represent patient's known tumor. This finding is associated with effacement of cortical sulci.5.recommend MRI examination for better evaluation.