Diagnosis: Benign neoplasm of cerebral meningesClinical question: Hx of suprasellar meningioma s/p RT, surveillance MRISigns and Symptoms: None The patient is status post right-sided craniotomy for removal of the anterior cranial fossa mass on the right side. There is some mild pachymeningeal enhancement present which is likely reactive in nature given the surgical history. There is redemonstration of encephalomalacia predominantly involving the right orbital gyrus and the gyrus rectus bilaterally. There is some involvement of the lateral aspect of the left orbital gyrus.There is an enhancing extra-axial mass present along the posterior aspect of the planum sphenoidale extending into the suprasellar cistern abutting the infundibulum of the pituitary gland and also abutting the distal internal carotid arteries bilaterally and the cisternal portions of the optic nerves and chiasm. It measures 14 x 10 mm sagittal dimensions on the current exam and previously measured 14 x 10 mm on 1/13/2015.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 are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.There is redemonstration of a change of an extra-axial mass at the posterior aspect of the planum sphenoidale and the suprasellar cistern which abuts the distal internal carotid arteries and optic nerves. This most likely represents a meningioma.2.Status post right-sided craniotomy.3.There is encephalomalacia present along the right orbital gyrus and gyrus rectus bilaterally as well as a small portion of the left orbital gyrus.