69 years, Female, evaluate mass. History of meningioma. Again seen are postsurgical changes related to prior left parietal parasagittal meningioma resection. There remains an approximately 7 mm focus of enhancement in the surgical bed with associated susceptibility compatible with chronic blood products and/or mineralization. No new or enlarging lesion is seen. There is T2/FLAIR hyperintensity with volume loss in the left parietal lobe related to encephalomalacia with adjacent gliosis. Several foci of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with mild chronic small vessel ischemic changes. Mild cerebellar tonsillar ectopia is again seen. No evidence of acute ischemia or hemorrhage. No extra-axial collections. No hydrocephalus. Major flow-voids are preserved. Calvarium and remainder of the extra-axial soft tissues are unremarkable.
Postoperative changes related to left parietal meningioma resection with unchanged gliosis in the left parietal lobe. There remains a subcentimeter nodular focus of enhancement in the left parietal surgical bed without interval enlargement. There is associated susceptibility which may be related to chronic blood products or mineralization. This finding is again favored to represent posttreatment change. No definite evidence of residual or recurrent meningioma.