Did you notice the right sided craniotomy? This patient had a prior minor debulking / biopsy. Unlike CT, craniotomies can be challenging to identify at first glance. What features are helpful?
Visualising the bony defect is of course useful, but often this is hard to see. The metallic fixation devices often result in susceptibility induced distortion or signal drop out. There is often linear post surgical dural thickening and the scalp scar may also be visible.
- blue arrow: the posterior pituitary bright spot has been pushed up and to the left by the meningioma
- red arrow: narrowed right internal carotid artery is significantly narrowed by the surrounding meningioma
- yellow arrows: craniotomy defect
- green arrow: susceptibility induced distortion and signal loss due to craniotomy fixation device