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What Do These CT Scan Findings Indicate?

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Posted on Wed, 6 Jan 2016
Question: What is your take on these recent findings?
The patient has undergone prior left craniotomy for resection of left frontal meningioma. There is residual anteromedial left frontal meningioma with the dominant nodular component measuring 1.1 x 1.8 x 2.6 cm in size slightly increased from 0.9 x 1.4 x 2.6 cm in size. Meningioma demonstrates dural tails which extend inferiorly along the floor of the left anterior cranial fossa (series 17/image 13) and laterally along the inner table of the left frontal calvarium (series 15/image 14). The lateral dural tail measures 3 mm in maximal thickness and is increased in size from minimal dural thickening on examination of October 22, 2014. A small amount of nodular enhancement within the left frontal resection cavity is likely postprocedural.
There is encephalomalacia within the left frontal lobe, T2/FLAIR hyperintensity within the underlying left frontal lobe is not changed in extent.
There is mild diffuse parenchymal volume loss. Prominent horizontal fissures within the cerebellum bilaterally are not changed dating back to earliest available study of July 8, 2006.
There is complete left maxillary sinus and near complete left frontal sinus opacification.
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Answered by Dr. Dr. Erion Spaho (24 minutes later)
Brief Answer:
Recidivate Meningioma, imaging follow up needed.

Detailed Answer:
Hello and thanks for using HCM.

I have read your query and understand your concerns.

Increase in size after one year means that there's recidive of the prior subtotally removed Meningioma that is progressing.

The decision to undergo surgery or not (surgery is the best option to treat Meningioma), depends on the grade of the previously removed Meningioma ( grade I, II, or III WHO ), anatomical location and related risks, and general health condition of the patient.

In my opinion, that is a small increase and imaging follow up for one or two years is sufficient.

Encaphalomalacia is a common finding after brain injury and usually isn't an issue.

Parenchymal volume loss of brain is more likely related to brain changes due to aging.

Opacification of sinuses is a finding after repeated sinuses infection ( sinusitis ).

Hope you found the answer helpful.

Let me know if I can assist you further.

Take care.
Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Answered by
Dr.
Dr. Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 4493 Questions

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What Do These CT Scan Findings Indicate?

Brief Answer: Recidivate Meningioma, imaging follow up needed. Detailed Answer: Hello and thanks for using HCM. I have read your query and understand your concerns. Increase in size after one year means that there's recidive of the prior subtotally removed Meningioma that is progressing. The decision to undergo surgery or not (surgery is the best option to treat Meningioma), depends on the grade of the previously removed Meningioma ( grade I, II, or III WHO ), anatomical location and related risks, and general health condition of the patient. In my opinion, that is a small increase and imaging follow up for one or two years is sufficient. Encaphalomalacia is a common finding after brain injury and usually isn't an issue. Parenchymal volume loss of brain is more likely related to brain changes due to aging. Opacification of sinuses is a finding after repeated sinuses infection ( sinusitis ). Hope you found the answer helpful. Let me know if I can assist you further. Take care.