74 years, Male, postop craniotomy for tumor resection.. There are expected postsurgical changes of left parieto-occipital craniotomy for tumor resection including small amount of pneumocephalus, blood products within and immediately surrounding the resection cavity as well as a thin extra-axial fluid collection beneath the craniotomy. There has been near total resection of the previously seen heterogeneously enhancing mass. There are areas of intrinsic T1 shortening with suspected thin residual enhancing tissue along the medial aspect of the resection cavity in the left parietal lobe as well as in the left posterior medial temporal lobe, suspected to represent minimal residual enhancing tumor. Enhancement again noted to extend to the ependymal surface of the left lateral ventricle. There is minimal rim of restricted diffusion surrounding the resection cavity margin related to blood products and cytotoxic edema. Again seen is extensive FLAIR hyperintensity in the left parietal, temporal, and occipital lobes. Effacement of the left lateral ventricle is also again noted as well as mild asymmetric dilatation of the right lateral ventricle. There is mild rightward midline shift similar to prior. No uncal herniation.Remainder of the brain demonstrates minimal foci of T2/FLAIR hyperintensity related to mild chronic small vessel ischemic changes but is otherwise unremarkable. Major flow-voids are preserved.
Expected postsurgical changes of resection of known GBM. There appears to be near total resection with minimal residual enhancing tumor suspected along the resection cavity margins in the parietal lobe and extending into the left posterior medial temporal lobe.