History of meningioma status post resection; surveillance. There are postoperative changes of prior left parietal craniotomy related to meningioma resection. There is redemonstration of a large area of encephalomalacia in the left posterior parietal lobe similar to prior study. There is mild dural based thickening along the posterior falx and along the left posterior parietal convexity similar to prior without discrete mass to suggest tumor recurrence.Again seen there is a small right frontal meningioma measuring approximately 8 x 5 mm, previously 8 x 3 mm, without significant interval change since 5/8/2010. In addition there is another right high frontal convexity meningioma which is minimally larger than the prior exam measuring 7 x 7 mm, previously 5 x 6 mm. There is no evidence of acute intracranial hemorrhage or acute infarction. 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 prominent enhancement at the left jugular foramen, unclear if this represents nonspecific distention of the left jugular vein versus an extrinsic enhancing mass compressing the left jugular vein.
1. Postoperative changes of left posterior parietal meningioma resection without evidence of tumor recurrence.2. Small subcentimeter right frontal meningiomas without local mass effect and stable to minimally larger than prior from 2010 allowing for differences in technique.3. There is prominent enhancement at the left jugular foramen, unclear if this represents nonspecific distention of the left jugular vein versus an extrinsic enhancing mass such as meningioma compressing the left jugular vein. Consider high resolution CT of the skull base with noncontrast and postcontrast images per CTV protocol.