Grade 2 meningioma treated with surgery and radiation therapy. There are post-treatment findings related to right parietal craniotomy and radiation therapy. There is interval increase in size of an enhancing dural based lesion deep to the craniotomy, with extension into the superior sagittal sinus that measures 14 x 12 mm, previously 11 x 8 mm. There is also interval increase in size of the enhancing dural-based lesion along the right lateral parietal convexity adjacent to the craniotomy flap margin that now measures 12 x 8 mm, previously 10 x 7 mm. There is non-opacification of portions of the posterior superior sagittal sinus. There is persistent high T2 signal and scattered areas of gyriform enhancement in the posterior parietal lobes near the midline. There is no evidence of acute cerebral infarction. The ventricles are stable in size and configuration. There is no midline shift or herniation. The skull and extracranial soft tissues are unchanged.
1. Interval increase in size of the residual tumor in the right parasagittal surgical bed and the recurrent tumor in the lateral right parietal convexity. 2. Persistent treatment effects in the bilateral posterior cerebral hemispheres, likely consisting of radiation necrosis.3. Persistent partial thrombosis of the posterior superior sagittal sinus.