Clinical question: Status post tumor resection. Signs and symptoms: Headache. Pre-and post-enhanced brain MRI:Examination demonstrate expected postoperative changes of a right frontal craniotomy for adrenal tumor. An irregular thin linear band of restricted diffusion surrounding the surgical cavity wall is within expected postop change.Surgical cavity CSF signal intensity and a small amount of expected postoperative hemorrhage layering in the dependent portion of cavity in the right frontal lobe is noted. Surrounding vasogenic edema demonstrate no significant change since prior study.There is significant decreased mass-effect since prior study and draped near complete resolution of midline shift to the left.Small amount of post operative hemorrhage is noted in the dependent portion of bilateral occipital horns.Mildly dilated left lateral ventricle demonstrate no significant change in size since prior study.Post enhanced images demonstrate no convincing evidence of enhancement in the surgical cavity or immediate surrounding parenchyma to suggest residual tumor. Further follow up however tis needed for assessment.
1.Expected postoperative changes of a right frontal craniotomy for removal of tumor.2.No convincing evidence of residual tumor on this initial postop study. Further follow up is recommended.3.Decreased in overall mass effect secondary to removal of tumor with only trace residual midline shift to the left.4.Stable mildly dilated left lateral ventricle since prior exam.5.Small postoperative blood in the dependent portion of occipital horns.