42 years Male (DOB:4/12/1974)Reason: history of L frontal brain tumor s/p resection and RT History: nonePROVIDER/ATTENDING NAME: STEVEN J. CHMURA STEVEN J. CHMURA The patient is status post left frontal craniotomy for left frontal lobe surgery. There is a small linear focus of enhancement present along the inferior medial aspect of the resection site which is stable compared to prior exam. There is also small focus of T1 signal hyperintensity adjacent to the frontal horn of left lateral ventricle. Perfusion imaging does not demonstrate any areas of increased microvascularity. The signal characteristics of the apparent fluid within the resection cavity are similar to spinal fluid.There is some leptomeningeal enhancement present in the left middle frontal gyrus which was also present on the prior exam and has not changed. This associated with some leptomeningeal FLAIR signal hyperintensity.There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images predominantly located in the left hemisphere. This was also present on the prior exam.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 are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.The patient is status post left frontal lobe surgery. The appearance of the resection site is stable compared to the prior exam. Small focus of enhancement at the surgical site remains stable. It is quite possible that it is related to postoperative effect.2.Leptomeningeal enhancement along the left middle frontal gyrus is stable compared to the prior exam. One possibility is that this represents collateralized venous flow.3.Left hemispheric periventricular white matter lesions present which are nonspecific but may be posttreatment related.