18 year old female with history of Ewing sarcoma now with metastases. Status post craniotomy for tumor resection. Patient has small postoperative subdural collection The patient is status post left frontal craniotomy appeared and there is an extra-axial hemorrhagic fluid collection of present underneath the craniotomy flap with a fluid fluid level associated some air bubbles. It is adjacent to the high convexities and measures approximately 9 mm in thickness . AP hypodense subdural component extends more posteriorly measuring approximately 5 mm in thickness and is also unchanged. There is mild midline shift the shift of the Falx cerebri up to approximately 6 mm to the right of the midlineA 0.7 cm hyperdense focus is present adjacent to the right chest appear frontal gyrus which has an extra-axial location. It was present on the MRI of 11/17/09.There is vasogenic edema present where the patient's known mass was paired this is edema pattern is stable since 11/19/09 MRI. There is some mass effect associated.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.Status post left frontal craniotomy for tumor surgery with the some findings which can be accounted for on the basis of a immediate postoperative effects such as a lobe of intracranial air and subgaleal soft tissue swelling.2.There is a left-sided subdural hemorrhagic fluid collection present with some mild mass effect and midline shift. This has not changed since the prior exam.3.A 7mm extra-axial hyperdense focus is present adjacent to the right superior frontal gyrus. This could represent a small meningioma.