Male, 44 years old, with cerebral cavernous malformation of the left brainstem, compare to outside images. Clinical symptoms of right arm and face numbness. Since the prior examination, a T1/T2 hypointense lesion within the left aspect of the pontomedullary junction has decreased in size, measuring up to 5 mm in diameter on T2 weighted images, previously over 10 mm. The lesion has lost nearly all of its previously seen bubbly T2 hyperintense characteristics, as well as its T1 hyperintense characteristics. The degree of associated susceptibility has also diminished. No significant surrounding edema is seen. At most, there may be a very subtle blush of associated enhancement which is not convincing for the presence of a developmental venous anomaly.No additional intracranial lesions are seen. No parenchymal edema or mass effect is detected. There are no abnormal extra axial fluid collections and the ventricles are normal in size and morphology.
1.Interval decrease in size of a hemosiderin stained lesion at the left ponto-medullary junction which, at least on prior imaging, had characteristic features for a cavernous malformation. The lesion is now hypointense on all sequences, having lost its prior T2 and T1 hyperintense features.2.No additional or new intracranial lesions are appreciated.