58 years Female (DOB:2/7/1958)Reason: PREOP STEALTH MRI, to be done at 6am in CCD prior to surgery; PLEASE PAGE NEUROSURGERY RESIDENT TO PLACE FIDUCIALS History: left lower extremity numbness, known cavernoma w previous bleedPROVIDER/ATTENDING NAME: ISSAM A. AWAD ISSAM A. AWAD There is redemonstration of a hemorrhagic focus centered in the right precentral gyrus and motor area associated with heterogeneous enhancement and a popcorn-like appearance on T2 imaging. There is a profound signal loss surrounding this lesion. It is unchanged compared to the prior exam.There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images. 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 partially opacified. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
Limited exam demonstrates cerebral cavernous malformation located in the right precentral gyrus. Examination is performed for stereotactic guidance during surgery.