Headache. History of Chiari. Also, history of hemangioma in the right orbit. Orbits: The well-defined avidly enhancing T2 hyperintense superotemporal intraconal mass within the right orbit is unchanged. It measures 12 mm maximally. The globes and ocular adnexa are unremarkable as well as the optic nerves. Brain: The cerebellar tonsils extend up to 12 mm inferior to the foramen magnum which is unchanged. Crowding of the level of foramen magnum but neural structures has not changed. There is biphasic flow anterior to the brainstem/upper cervical spine and a blush of flow posteriorly. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is a left frontal developmental venous anomaly. There are minimal scattered foci of T2 hyperintensity in the cerebral white matter which are unchanged. The brain parenchyma otherwise appears unremarkable. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is very minimal ethmoidal mucosal thickening without fluid, most likely of no significance. The small T2 hyperintense focus along the posterolateral aspect of the right mandibular condyle has not changed and may represent a small synovial cyst.
1.Findings compatible with Chiari malformation are not anatomically changed. There is CSF flow across foramen magnum as described above.2.The 12 mm, well-defined avidly enhancing T2 hyperintense superotemporal intraconal mass within the right orbit is unchanged and as described previously most likely represents a cavernous hemangioma.