52-year-old man status post craniotomy for tumor resection. Evaluate postoperative changes. There are postoperative findings related to right frontal and temporal craniotomy with blood products\within the resection cavities and persistent surrounding T2 signal abnormality compatible with vasogenic edema. The edema results in mass effect with sulcal effacement in the right frontal lobe, partial effacement of the right lateral ventricle, and approximately 8 mm of midline shift to the left. The basal cisterns are maintained. There is no residual abnormal enhancement in the frontal lobes. There are unchanged punctate foci of abnormal enhancement in the bilateral cerebellar hemispheres, with associated susceptibility artifact in the right-sided lesion. There are small areas of restricted diffusion surrounding the resection cavities, but no evidence of territorial acute ischemia. The major cerebral flow voids are intact. There is dolichocephaly.
1.Status post resection of right frontal lobe metastases without evidence of gross residual tumor, but persistent vasogenic edema with associated midline shift of 8 mm.2. Punctate lesions in the bilateral cerebellar hemispheres likely represent metastases.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.