New dizziness, hypotension, bradycardia. Again seen is heterogeneous increased T2 signal intensity left carotid space mass with internal flow voids. This lesion up to 33 x 33 x 44 mm, previously measured as 32 x 29 x 41mm AP x TV x CC. The lesion displaces the left carotid arteries and bifurcation laterally, and the left internal jugular vein posterolaterally. Minimal effacement of the adjacent left oropharyngeal airway is again identified without appreciable change.No new lesions are identified. There are no pathologically enlarged lymph nodes noted.Moderate degenerative changes are seen in the cervical spine with multilevel disc osteophyte complexes, particularly C3-C4, C4-C5, and C5-C6 levels with up to moderate multilevel spinal canal and neural foraminal stenoses.Diminutive right vertebral artery flow-void is again seen which may be related to proximal high-grade stenosis. Vasculature is relatively better assessed on prior MRA neck study.
Compared to 9/22/2012, there is minimal gradual enlargement of left carotid space mass, which is compatible with a carotid body tumor. 