Residual enhancement is evident from the initial pre-operative administration of Gd.
While the resection was felt to be only partial, very little relative enhancement is noted after the addition of more Gd. This situation likely arose from the sacrifice of 2 major feeder arteries to the tumor during the resection. The enhancement properties of the lesion can be markedly changed as a result. This demonstrates another difficulty in the intraoperative interpretation of enhancing lesions.