74 years, Female, status post craniotomy for tumor resection. There are immediate postsurgical changes related to left parietal craniotomy for resection of lesion involving the left precentral gyrus. There has been resection of at least a majority of the lesion with blood products filling the resection cavity at the site of prior lesion. There is some intrinsic T1 hyperintensity and peripheral enhancement surrounding the resection cavity; note no adequate prior post gadolinium sequences are available for comparison as noted on prior preop report. There is mild restricted diffusion surrounding the resection cavity compatible with blood products and mild cytotoxic edema. Left frontoparietal vasogenic edema surrounding the resection cavity is similar to prior.Again seen are several foci of T2/FLAIR hyperintensity in the bilateral subcortical and periventricular white matter as well as the pons, which are nonspecific, but compatible with chronic small vessel ischemic disease. No additional enhancing lesions are seen elsewhere in the brain. No hydrocephalus. No midline shift or herniation. Partially empty sella incidentally noted. No suspicious lesions involving the calvarium or visualized extracranial soft tissues.
Expected postsurgical changes related to resection of lesion involving the left precentral gyrus. There is peripheral rim of enhancement surrounding the resection cavity with minimal residual tumor not excluded and can be assessed on future follow-up study.