21 years Female (DOB:9/15/1994)Reason: s/p 2014 meningioma resection and SRS, please evaluate for changes History: s/p 2014 meningioma resection and SRS, please evaluate for changesPROVIDER/ATTENDING NAME: ISSAM A. AWAD ISSAM A. AWAD MRI brain:The CSF spaces are appropriate for the patient's stated age with no midline shift. There is redemonstration of status post left-sided craniotomy. A focus of encephalomalacia is present along the anterior aspect of the left frontal lobe. This appearance is stable compared to the previous exam.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrate a mucous retention cyst in the right sphenoid sinus and mucous retention cysts in the maxillary sinuses bilaterally.. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are partially obscured by high motion and susceptibility artifact..MRI pituitary:There is redemonstration of a heterogeneously enhancing left parasellar mass which currently measures 18 x 16 mm coronal dimensions and previously measured 20 x 18 mm coronal dimensions. It currently measures 22 x 16 mm sagittal dimensions and previously measured 23 x 18 mm sagittal dimensions. It abuts the left internal carotid artery and partially surrounds it also abuts the superior aspect of the left cavernous sinus and the left posterior clinoid process. It extends along the superior lateral aspect of the sella. It abuts the optic chiasm along its medial aspect. Laterally it abuts the medial aspect left temporal lobe.The pituitary gland is appropriate in overall height and morphology. The infundibulum of the pituitary gland is midline. No intrasellar mass is identified. The cavernous sinuses are intact bilaterally.
1.A left parasellar mass is slightly smaller on the current exam when compared to the prior. It affects critical structures adjacent to it as detailed above.2.Status post left-sided craniotomy associated with post surgery changes.