 There is a small lesion within the posteromedial left thalamus measuring 7 x 6 mm (as measured on the axial T2 technique), previously 5 x 5 mm. The hypointense rim is slightly larger. Internal signal characteristics now demonstrate less T2 hyperintensity and more T1 hypointensity. As before, there is no perilesional edema. There are no other similar appearing lesions. There are no associated developmental venous anomalies. There are a few scattered punctate foci of T2 hyperintensity in bifrontal subcortical white matter locations without mass effect, restricted diffusion, susceptibility abnormality, or enhancement. The ventricles and sulci are normal in size. The cerebellar tonsils are in normal position. There is no mass effect or midline shift. The pituitary gland is normal in size. There is no evidence for intracranial hemorrhage or acute cerebral, brainstem or cerebellar infarction. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. The paranasal sinuses and mastoid air cells are clear. There is no abnormal enhancement within the brain.
Small, 7 x 6 mm, cavernous malformation within the left thalamus as described in detail above. There is no associated perilesional edema or development of venous anomaly.