Seizures. Evaluate for abscess status post cavernous malformation resection. There are postoperative changes of a left posterior temporal craniotomy for cavernous malformation resection. There is high T1 signal surrounding resection cavity and susceptibility effect indicating postoperative edema and blood blood products. There is minimal rim of peripheral enhancement along the edge of the resection cavity as well as enhancement of the adjacent dura which is nonspecific and likely related to the postsurgical changes. Peripheral restricted diffusion along the resection cavity could be from the sequela of cytotoxic edema or blood products themselves. No central restricted diffusion to suggest purulent material within the cavity. The size of the surgical cavity and edema are grossly similar to minimally larger from prior CT allowing for differences in technique. There are no abnormalities elsewhere in the brain. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. Mild scalp soft tissue thickening and minimal extra-axial fluid in the left parietal region is also related to postoperative changes. The major cerebral flow voids are intact. A mucous retention cyst or polyp is present in the right maxillary sinus. The orbits, skull, and scalp soft tissues are grossly unremarkable.
Evolving postoperative changes related to resection of left posterior temporal cavernous malformation. There is no specific evidence of intracranial infection, with blood products along the resection cavity, mild surrounding edema, and enhancement which may represent evolving postsurgical changes. If there is high suspicion of intracranial infection, follow-up imaging may be obtained.