Female, 66 years old, with history of craniotomy for resection of parafalcine meningioma with progressive weakness. Again seen is evidence of craniotomy at the high vertex. A partially resected falcine meningioma is again seen. Enhancement along the left aspect of the resection cavity has become thicker when compared to the prior examination though it remains nonspecific. Nodular enhancement along the right aspect of the resection cavity has also become thicker than on prior and likely represents residual tumor. The parenchyma of the adjacent superior frontal gyri is edematous, but this appears grossly similar to the prior examination.Evidence of prior left frontal and parietal craniotomy is again seen with the resection cavity evident in the left middle frontal gyrus. Findings are unchanged. An 8 mm nodule of enhancement along the left superior temporal gyrus is unchanged. An enhancing focus within the left squamous temporal bone is also unchanged.On MRV imaging, the superior sagittal sinus directly beneath the craniotomy is flattened and narrowed, largely due to anatomic changes related to craniotomy. However, there does remain a distinct flow related signal throughout the sinus indicating patency. The dural venous sinuses and deep venous structures are otherwise patent.
1.Sequelae of partial resection of the falcine meningioma are again seen. Nodular enhancement along the right aspect of the resection cavity is favored to represent residual tumor and has become thicker in the interval. Enhancement along the left aspect of the resection cavity has also become thicker but it remains nonspecific and could represent evolving postoperative change with granulation tissue or some residual tumor as well.2.MRV imaging demonstrates mass effect upon the superior sagittal sinus as it passes beneath the high vertex craniotomy. However, the sinus remains patent.3.Findings are redemonstrated compatible with prior left sided surgery. A small presumed meningioma along the left superior temporal gyrus is also unchanged.