5-year-old female with hemangiomas of intracranial structures. Clinical question: Multiple cerebral cavernous malformations brain , + CCM3 gene, history left sided weakness, headaches, yearly evaluation please do on 3T with ccm protocol. Signs and Symptoms: yearly surveillance The CSF spaces are appropriate for the patient's stated age with no midline shift. Redemonstrated is a heterogeneous pontine mass currently measuring 19 x 22 mm (previously 19 x 24 mm) as measured on the axial T2 sequence, demonstrating slight interval decrease in size primarily due to a smaller intralesional cystic cavity on the right. Fluid fluid levels are less conspicuous, and there has been expected evolution of internal hemorrhagic components. The surrounding hypointense rim is unchanged in appearance and there is no new perilesional edema.Previously identified lesions within the anterior left temporal lobe, the more posterior left temporal lobe, along the medial right periatrial white matter, and involving the right occipital lobe are unchanged in appearance.Incidental note is made of a small developmental venous anomaly within the medial right frontal lobe without associated susceptibility abnormality focus. 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 and demonstrate some mucosal thickening. The visualized portions of the mastoid air cells demonstrate partial opacification of right mastoid air cells. The visualized portions of the orbits are intact.
1.The patient's pontine cavernous malformation has decreased in size compared to the prior exam, primarily due to a smaller intralesional cystic cavity on the right. Fluid fluid levels are less conspicuous, and there has been expected evolution of internal hemorrhagic components. The surrounding hypointense rim is unchanged in appearance and there is no new perilesional edema.2.Stable cavernous malformations elsewhere.