Reason: s/p tumor resection. please do full brain MRI and 1mm stealth without fiducials History: meningioma Since the prior exam the patient has undergone frontal craniotomy for removal of a frontal lobe meningioma. There are some attendant postoperative changes present within the scalp tissues.There are foci of residual tumor present along the anterior cranial fossa at the floor in the midline measuring 53 x 34 mm in axial dimensions involving the cribriform plate and the adjacent intracranial fossa floor. Another residual component is present which is adjacent to the corpus callosum along the midline measuring 25 x 11 mm sagittal dimensions and 23 x 40 mm axial dimensions.There is elevated T2 and flair signal involving medial aspects of the frontal lobes bilaterally associated with some microhemorrhages. More prominently the portion of the frontal lobe brain parenchyma previously anterior to the contain some microhemorrhages and signal change and has a reexpanded into the tumor bed.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 opacification of the frontal sinuses and mucosal thickening ethmoid air cells and the maxillary sinuses as well as the sphenoid sinus. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.The patient is status post bifrontal craniotomy for removal of large meningioma . The clear majority of the meningioma has been removed. There are a couple foci of residual tumor present along the floor of the intracranial fossa and cribriform plate as well as adjacent to the corpus callosum.2.There are attendant postoperative changes present as detailed above.The posterior wall of the frontal sinus is not clearly defined.