Reason: CCM Protocol, QSM, Permeability, 3T Scanner; s/p resection of brainstem lesion History: Weakness, speech problems The patient has undergone a right temporal lobe surgery. Since the prior exam or extra-axial fluid collection and a additional postoperative findings have regressed. Since the prior exam the patient has evolved to encephalomalacia along the anterior aspect of the right temporal lobe. There is associated vacuum effect on the temporal horn of the right lateral ventricle.There is redemonstration of multiple popcorn-like lesions with a dark surrounding rim and a heterogeneous central portion on the T2 image and located in the region of the right cerebral peduncle and adjacent deep gray nuclei, the left temporal lobe and the right frontal lobe. There is redemonstration of multiple punctate lesions scattered throughout the brain parenchyma. The right cerebral peduncle lesion is somewhat smaller on the current exam when compared to the prior. The left temporal lobe lesion and the right frontal lobe lesion remain relatively stable. The right frontal lobe lesion currently measures 14 x 10 mm axial dimensions previously measured approximately the same there the left temporal lobe lesion previously measured 11 x 11 mm currently measures approximately the same.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 clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits demonstrate elongation of the AP dimension of the eyes similar to the prior exam.
1.A right frontal lobe in the left temporal lobe cerebral cavernous malformation are stable.2.The patient has undergone right-sided craniotomy. Since the prior exam cavernoma occupying the right cerebral peduncle and adjacent gray matter has decreased in overall size.3.There is encephalomalacia along the anterior aspect of right temporal lobe.4.Multiple punctate hemorrhagic lesions are scattered throughout the brain parenchyma which also present on previous exams and suspected to be related to the patient's cerebral cavernous malformations.