57-year-old male patient with prior meningioma and craniotomy. Headaches. There are postsurgical changes of a left frontal craniotomy with underlying encephalomalacia of the left frontal lobe and to a lesser degree the anterior right frontal lobe, appearing similar to the prior study. There is a new region of extra-axial thickening and enhancement about the left frontal convexity along the posterior aspect of resection margin measuring approximately 9 mm in the craniocaudal dimension and 4.4 cm in the transverse dimension (image 11, series 1101). This extra-axial thickening causes mild mass effect on the underlying left frontal lobe without white matter edema. The remaining brain parenchyma is unremarkable. The ventricular system is stable in size. The basal cisterns are patent. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits and paranasal sinuses are grossly unremarkable.
1. Post-surgical changes related to resection of a left frontal meningioma with frontal lobe encephalomalacia. 2. New left frontal convexity extra-axial thickening and enhancement about the posterior aspect of the posterior resection margin is concerning for recurrent disease. 