Male 74 years old, evaluate left temporal lesion, episode of gait unsteadiness (resolved), small hyperdensity on CT Motion degrades sensitivity.There is redemonstration of a small left temporal lobe lesion with punctate central enhancement and mixed T2 signal measuring up to 7 mm (1701/156). The lesion demonstrates blooming on SWI with a complete peripheral T2 hypointense hemosiderin rim. No associated surrounding FLAIR hyperintensity or mass effect noted. An asymmetric branching area of susceptibility/enhancement posterior medially adjacent to the lesion is consistent with a developmental venous anomaly as seen on prior CTA dated 6/5/2016. Otherwise, the surrounding brain parenchyma demonstrates normal signal. Prominent curvilinear area of increased susceptibility (1001/91) along the left occipital sulci without an associated asymmetric vessel prominence on postcontrast images. There is no associated parenchymal abnormality. There are no other foci of abnormal susceptibility identified.Patchy areas of increased T2/FLAIR signal most prominent in the periventricular and subcortical areas suggestive of chronic white matter small vessel ischemic disease.There is no acute infarct. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. Minimal fluid is present in the right mastoids. The orbits, skull, and scalp soft tissues are grossly unremarkable.
1. Left temporal lobe cavernous malformation with associated developmental venous anomaly, consistent with findings noted on CTA dated 6/5/2016. No other cavernous malformations identified.2. Curvilinear area of increased susceptibility in left occipital sulcus without correlating asymmetric vessel prominence on postcontrast images, although images are limited by patient motion. Findings may represent the remote possibility of small thrombosed vessel, or could in part be artifactual. No associated parenchymal abnormality.