Meningiomas. Status post resection. Assess for recurrent/growth. Since the previous examination, the patient did have resection of the left anterior parietal convexity meningioma. There is a small focus (measuring 7 mm in diameter) of somewhat linear contrast enhancement in the treatment bed which may reflect the leptomeningeal scarring. The diffusion characteristics in the treatment plan and are difficult to assess given artifact related to the overlying craniotomy. However, there is no sizable effusion obstruction. Ureteral thickening underlying the craniotomy flap than expected.T1-hypointense, T2 hyperintense signal without mass-effect in the underlying anterior parietal white matter (including the postcentral gyrus) probably reflect gliosis. This is where the edema-like signal was present on the preoperative examination. The remainder of the brain shows unchanged tiny subcortical and deep white matter foci in the frontal lobes that probably reflect chronic microvascular ischemia. There is mild expansion of the ventricle system and the other CSF-containing spaces which is unchanged.The orbits are normal. The mastoid air cells and the paranasal sinuses are clear.
1.The patient did have resection of the left parietal paramedian convexity meningioma. 2.Seven millimeter focal contrast enhancement in the resection bed likely represent leptomeningeal scarring rather than residual tumor. However, follow-up MRI can more reliably rule out minimal residual tumor though.