Previous craniofacial resection of ethmoid chondrosarcoma years ago. Since, difficulty with anger management, drug use and memory.
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Extensive bony resection in the nasal cavity and adjacent paranasal sinuses is again noted. A small amount of persisting enhancement is noted within the floor of the anterior cranial fossa. There is unchanged encephalomalacia in the inferior frontal lobes adjacent to this. No new nodular focal enhancement to suggest recurrence. Mucus retention cysts are noted in the left nasal cavity superiorly. Fluid is again noted in the left sphenoid sinus.
Bifrontal encephalomalacia can have significant neuropsychiatric sequelae, and should be looked for carefully in patients with frontal lobe symptoms. In this instance a significant surgical history is present, but often such change can be the result of closed head injury, the inferior frontal lobes being typical locations for hemorrhagic contusions.