Clinical question: Rule out hemorrhage. Signs and symptoms: Post op. Nonenhanced CT of brain:Examination demonstrates expected postoperative changes of left suboccipital craniotomy. There is minimal residual fluid and air under the craniotomy flap, minimal residual air within the subarachnoid space in both supra-and infratentorial space. Minimal punctate high density at the expected level of the left foramina of Luschka is noted. There was tumor at this site on prior exam. This findings has the appearance of calcification and or hemorrhage which may be a postop change or represent residual tumor. This finding measures approximately 7 mm times 14-mm in size and should be further followed with an MRI examination. Subtle mass effect on the fourth ventricle with minimal deviation to the right is similar to prior study. There is no evidence of any opacification of mastoid air cells although the craniotomy line traverses the posterior mastoid air cells. Middle ear cavities are well pneumatized and unremarkable. A retention cyst within the left chamber of the sphenoid sinus is noted.
1.Expected postoperative changes of left suboccipital craniotomy for removal of left cerebellopontine angle tumor.2.Suspect small residual tumor in the left cerebellopontine angle and follow-up with an MRI is recommended.3.No evidence of acute hemorrhage or cerebral edema.