History of syncope and possible seizure, evaluate for meningioma growth. There is a dural based extra-axial mass in the anterior left middle cranial fossa along the greater wing of the sphenoid, which measures 32 x 19 x 30 mm, previously 31 x 17 x 28 mm. The lesion demonstrates avid homogeneous enhancement. There is resultant mass effect and posterior displacement of the left temporal tip without parenchymal signal abnormality to suggest vasogenic edema. There are scattered punctate foci of high T2 signal within the periventricular and subcortical white matter, basal ganglia, and pons, which are nonspecific but compatible with chronic small vessel ischemic changes. There is no evidence of intracranial hemorrhage or acute infarct. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. There is mild mucosal thickening within the visualized paranasal sinuses. The orbits and scalp soft tissues are grossly unremarkable.
The left anterior middle cranial fossa extra-axial mass, which is compatible with meningioma, has slightly increased in size.