Drug-resistant epilepsy (complex partial seizures with secondary generalization). Status post VNS placement in 3/2015. History of ependymoma resection in 2002. The presence of VNS device required adjusting the exam parameters resulting in less signal-to-noise ratio and suboptimal quality of the study.Underlying the synthetic right frontoparietal craniotomy graft, there are findings of previous resection from the right frontal lobe with adjacent gliosis and cystic encephalomalacia. This is associated with ex vacuo enlargement of the adjacent parts of the right lateral ventricle and the adjacent sulci. Aside from hemosiderin staining along the resection margin in the right frontal lobe, there is no intracranial hemorrhage. There is no acute infarct. There is no space-occupying or contrast-enhancing brain lesion. There is no mass-effect or brain herniation. Bilateral hippocampi demonstrate preserved internal architecture, volume, and signal without findings to suggest mesial temporal stenosis. The major intracranial vascular flow voids are preserved. There is a small retention cyst in the left maxillary sinus with centrally desiccated secretions. There is trace mucosal thickening in the other paranasal sinuses. A small midline nasopharyngeal mucosal cyst likely represents a Thornwaldt or mucous retention cyst.
1.Sequela of prior right frontal lobe tumor resection including a resection cavity with adjacent encephalomalacia/gliosis. There is no abnormal enhancement or discrete mass to suggest tumor recurrence. Comparison with prior studies would be helpful if available. 2.Remainder of the brain is otherwise within normal limits.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.