Diagnosis: Hemangioma of intracranial structures Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, intractable, without status epilepticus Hemiplegia, unspecified affecting unspecified side Other amnesiaClinical question: h/o CCM; please do on 3T with CCM protocol/QSM/permeabilitySigns and Symptoms: surveillance; seizures There is a hemorrhagic lesion centered in the left thalamus which extends to the adjacent internal capsule and centrum semiovale which has a popcorn-like appearance on T2-weighted imaging. This measures 22 x 18 mm coronal dimensions. It is contiguous with the ependymal lining of the left lateral ventricle and mildly protrudes into the trigone of the left lateral ventricle. This lesion is stable since the prior exam.There is a hemorrhagic lesion present within the posterior aspect of the right temporal lobe along the superior temporal gyrus with a 6 adjacent lesion at the right supramarginal gyrus. These lesions abut the subarachnoid space. These lesions are stable since the prior exam.There is a small lesion measuring approximately 8 mm along the right pons at the junction of the right middle cerebellar peduncle and adjacent to the right trigeminal nerve. This abuts the subarachnoid space and the root entry zone of the right trigeminal nerve. This lesion is stable since the prior exam.In addition to the above described lesions are multiple punctate foci of signal hypointensity throughout the brain parenchymaNormal 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 mucosal thickening within the left maxillary sinus and to lesser degree right maxillary sinus. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
There are multiple lesions within the brain parenchyma compatible with multiple cavernomas which are stable since the prior exam.