Other malformations of cerebral vessels [Q28.3], Reason for Study: ^Reason: Right medial temporal lobe and the right frontal mixed signal lesions, likely represent History: headaches There is about 5mm sized right fusiform gyrus multiple conglomerated T2 high signal lesion with surrounding hemosiderin deposition. There is also right insular subcortical white matter lesion with similar MR characteristics.In addition, there is a small susceptibility lesion on the posterior aspect of the right middle temporal gyrus. All three lesions do not show any evidence of surrounding edema.Regarding the right fusiform gyrus and right anterior insular lesions, the central T2 high signal intensity portion appears to be slightly smaller than before, however, surrounding hemosiderin deposition appears to be larger.The right posterior middle temporal gyrus lesion was not seen on prior scan. However, since there was no compatible sequence to that of current Gradient echo or CCM sequence, it is not clear if the lesion is a new one or was there before.There is no evidence of abnormal enhancement on this scan.Constellation of above findings indicate 3 cavernous malformations with interval evolution of 2 lesions and newly found one small lesion.The ventricles, sulci and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra or extra-axial fluid collection, restricted diffusion/acute ischemia, or abnormal contrast enhancement. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.
1. Three cavernous malformations are demonstrated without evidence of surrounding edema or enhancement. 2. Both right fusiform gyrus and anterior aspect of the insular lesions show interval change of MR feature. In particular, decreased size of central T2 high signal intensity portion and increased extent of surrounding hemosiderin deposition since prior scan.3. Posterior aspect of the right middle temporal gyrus lesion is a new lesion found on this scan, however, due to difference in MR technique, the lesion could have been unfound from prior scan.4. No evidence of acute ischemic or hemorrhagic lesion on this scan. No abnormal enhancement.