Findings:
Postsurgical area of encephalomalacia is seen in the right temporal pole, extending superiorly to the right orbital gyri with associated gliosis and ex-vacuo dilatation of the right temporal horn. On the postcontrast study mild thickening and enhancement of the convexity meninges is seen in the right temporal pole, likely post-operative in nature. Additionally, a 5 mm measuring nodular enhancement is seen in the right temporal pole, which could represent a small residual tumour.
A few, non-specific foci of T2/FLAIR hyperintensity are noted in bilateral cerebral hemispheres. The brain parenchyma is otherwise unremarkable. No diffusion restriction.
The Circle of Willis is normal with conventional anatomy. No evidence of stenosis or aneurysm is seen.
The left superior cerebellar artery is coursing just above the left trigeminal nerve abutting and indenting its superior surface with marked decreased girth of the left trigeminal nerve along its cisternal segment.
Additionally, the left vertebral artery contacts the facial nerve at the nerve root entry zone.
The vestibular-cochlear apparatus and internal acoustic canals have a normal appearance. No structural cochlear abnormalities. No CPA mass lesion.
The pituitary gland is normal.
A small mucous retention cyst is seen in the right maxillary sinus.
The orbits, paranasal sinuses and mastoid air cells are otherwise clear.
No bony abnormality is seen. The craniocervical junction is normal.
Conclusion:
Post-operative resection cavity on the right temporal pole. Minimal residual tumour cannot be ruled out.
Neurovascular compression of the left facial nerve at its nerve root entry zone by the left vertebral artery.
Features of left trigeminal neuralgia due to compression of the trigeminal nerve by the left superior cerebellar artery with chronic atrophic changes of the left trigeminal nerve.