History of suprasellar meningioma status post resection. There are post-surgical changes related to a right frontotemporal craniotomy for suprasellar meningioma resection. There is redemonstration of encephalomalacia in the right inferior frontal lobe at the site of previously resected meningioma as well as laminar necrosis along the cortex similar to prior exam. There is faint enhancement in the sella with decreased band of enhancement along the superior aspect of planum sphenoid extending along the floor of the right anterior cranial fossa laterally to the craniotomy flap in the right temporal region, likely reflecting post-operative change.There are subtle subcentimeter areas of heterogeneous enhancement at the medial aspect of the left cavernous sinus as well as the right aspect of the suprasellar cistern. There is unchanged increased T1 hyperintensity in the right inferior basal ganglia. There is no evidence of acute intracranial hemorrhage or acute infarct. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The skull and extracranial soft tissues are unremarkable.
Evolution of postoperative changes related to a right frontotemporal craniotomy for suprasellar meningioma removal. Subcentimeter heterogeneous areas of enhancement at the medial aspect of the left cavernous sinus as well as the right aspect of the suprasellar cistern, may represent minimal residual tumor, but are not significantly changed from prior exam. No evidence of tumor progression.  