Post craniotomy for glioblastoma multiforme resection. There are postsurgical changes related to recent reexcision of left parieto-occipital tumor, as well as foci of susceptibility relating postoperative air and blood products along the surgical tract. Overall, the previous peripherally enhancing cavity has slightly decreased in size, and there is decreased confluence of heterogeneous enhancement along its superior margin. There has also been interval decreased thickness of the rind of heterogeneous enhancement along the lateral aspect of the mass. On MRI 10/18/16 this enhancing rind measured up to 9 mm in greatest thickness, now measuring 4 mm. There is similar extent of ependymal enhancement of the occipital horn of the left lateral ventricle. The vasogenic pattern of T2/FLAIR hyperintensity within the left temporal and occipital lobe white matter has slightly progressed since 9/28/2016, with slight increased expansion of the tissue, and increased extension into the left splenium. There is effacement of the occipital horn of the left lateral ventricle, similar to prior. There is no midline shift or herniation. The pituitary gland is unremarkable. The basilar cisterns are maintained. The major cerebral flow voids are intact.There is a subcortical enhancing curvilinear structure identified in the right temporal lobe (series 12 and 2, image 113) is likely a developmental venous anomaly.
1.Expected postsurgical changes related to recent left parieto-occipital tumor recent reexcision. Decreased thickness of lateral rind of enhancement as well as decreased nodular enhancement noted superiorly, with overall decreased size of the otherwise similar appearing cavity, consistent with interval resection which may be subtotal.2.Unchanged left occipital ependymal enhancement, likely representing spread of tumor. 3.Unchanged vasogenic pattern of nonenhancing nonspecific T2/FLAIR hyperintensity, with effacement of the left occipital horn, though slightly progressed since 9/28/2016.