53 year-old female status post aneurysm clipping with known cerebral cavernous malformation disease. Annual surveillance. Redemonstrated are postsurgical changes from a left-sided craniotomy for placement of an aneurysm clip in the region of the anterior communicating artery. Susceptibility from the aneurysm clip obscures local structures. Encephalomalacia with adjacent gliosis is noted involving the anterior left temporal lobe. These findings are stable in appearance.Redemonstrated are a few scattered punctate foci of T2 hyperintensity primarily in subcortical white matter locations without associated mass effect, restricted diffusion, enhancement, or susceptibility abnormality. These are unchanged in appearance.There are no new masses, mass effect, or midline shift. Ventricular sizes are within normal limits.Redemonstrated is susceptibility artifact involving the left occipital lobe, unchanged in appearance, without associated perilesional edema. Additionally, enhancement images demonstrate an associated developmental venous anomaly. A small rounded focus of susceptibility is again noted involving the posterolateral right putamen, without associated developmental venous anomaly, and without perilesional edema, unchanged in appearance. There are no other foci of susceptibility abnormality.Paranasal sinuses and mastoid air cells remain clear. Orbital contents remain unremarkable.
1.Stable susceptibility focus involving the left occipital lobe, consistent with a cavernous malformation, without perilesional edema, associated with a developmental venous anomaly. 2.A small rounded focus of susceptibility is again noted involving the posterolateral right putamen, without associated developmental venous anomaly, and without perilesional edema, unchanged in appearance. This may represent a tiny cavernous malformation versus mineralization or prior microhemorrhage.3.Stable postprocedural changes secondary to prior aneurysm clipping.