34 years Male (DOB:12/16/1981)Reason: 3T scanner, CCM Protocol, QSM/permeability; s/p cavernoma resection on 4/8/16. History of prior resections and radiation. History: Bilateral weakness, rt. side numbness, gait problems, double vision, s/p craniotomyPROVIDER/ATTENDING NAME: ISSAM A. AWAD ISSAM A. AWAD There is redemonstration of a hemorrhagic lesion centered in the left pons but also involving the left middle cerebellar peduncle which currently measures 32 x 41 mm . On the 4/10/2016 exam it measured 38 x 41 mm. When compared to the 4/10/2016 exam a previously noted cystic component along the medial aspect of the lesion has regressed.. A hemorrhagic lesion within the right cerebral peduncle is redemonstrated. There is more susceptibility effect the associated with the current exam versus the prior exam.Another hemorrhagic lesion in the left upper posterior midbrain has also changed character but appears to have less T2 signal hyperintensity centrally slightly less cystic.A high signal intensity lesion on T2 imaging in the left medulla remains stable. T2 signal hyperintensity along the posterior aspect of the left cerebellar hemisphere also remains stableThere is a developmental venous anomaly redemonstrated in the left cerebellar hemisphere inferiorly.The patient is status post suboccipital craniotomy.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrate a mucous retention cyst in the left maxillary sinus as well as minor opacities in the left ethmoid air cells. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.There is redemonstration of multiple cerebral cavernous malformations in the brainstem and cerebellum associated with a left cerebellar developmental venous anomaly. These have mildly changed character and size when compared to the prior exam from 4/10/16.2.Status post posterior fossa surgery.