Diagnosis: Encounter for examination for normal comparison and control in clinical research programClinical question: metastatic breast cancer r/o brain mets prior to starting on a clinical trial The CSF spaces are appropriate for the patient's stated age with no midline shift. There is an ill-defined focus of enhancement present on the left half of the pons measuring 10 x 8 mm sagittal dimensions and 10 x 10 mm coronal dimensions which is predominantly high signal on T2, relatively subtle high signal on FLAIR and low signal on susceptibility imaging. On susceptibility imaging there appear to be serpiginous flow-voids associated with this. This is also identified on the CT scan from 3/2/2015 No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.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 are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.There is a punctate focus of signal loss on susceptibility imaging located in the left temporal lobe subcortical white matter along the left inferior temporal gyrus without any associated contrast enhancement.
1.There is a lesion present within the left pons. It is suspected to represent capillary telangiectasia, however, given the patient's clinical history of metastatic breast cancer a follow-up exam to further evaluate this would be prudent to ensure this doesn't represent an unusual metastatic focus.2.Left temporal lobe microhemorrhage in isolation is of unknown significance.