s/p left craniotomy with grid placement attempt post surgical follow up, epilepsy patient. No evidence of acute ischemic or hemorrhagic lesion on this scan.Evidence of left fronto-temporo-parietal craniotomy with think subdural fluid collections underneath of the craniotomy site.There is no evidence of intra parenchymal hemorrhage or ischemic lesions on this scan.Again, there is redemonstration of polymicrogyria involving the superior aspect of the left sylvian fissure over the left parietal and temporal lobe, as well as some of the left frontal lobe. The left hemisphere shows volume decrease. These findings do not show any significant interval change since prior exam.The right hemisphere appears to be within normal limits.There are multiple tubular signal voids on the surface of the left hemisphere, again no significant interval change since prior exam.The ventricles, sulci and cisterns are unremarkable. The mucosal thickening on bilateral paranasal sinuses and mastoid air cells show fluid collections.3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate normal ICAs, MCAs and ACAs. Vertebrobasilar system appears to be normal.There are linear intra luminal low signal intensities on bilateral distal ICAs around paraclinoid segments which likely represent flow related artifacts.
1. Post left fronto-parieto-temporal craniotomy status with postoperative fluid collections underneath of craniotomy. Postoperative no unusual finding.2. No evidence of acute ischemic or hemorrhagic lesion on this scan.3. Enlarged cortical veins, however, there is no evidence of intracranial arterial aneurysm, arterial luminal stenosis 