Reason: right parietal lesion? History: seizure.Additional history from EMR: Fell out of hairdressing chair with subgaleal hematoma. Outside CT showed right parietal hematoma. MRI brain:There is a rounded area in the right parietal lobe measuring 1.6 x 1.9 cm with increased T1 signal and susceptibility, compatible with hemorrhage. A fluid level and hemosiderin rim, as well as focal eccentric T2 hypointensity and susceptibility suggests blood products of various ages. There is no significant enhancement and only adjacent minimal edema. No obvious abnormal vasculature is associated with the lesion. No significant mass effect.There is no evidence of acute infarct. Left temporal lobe developmental venous anomaly is noted. Ventricles are mildly asymmetric but not enlarged. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.MRA brain:The intracranial internal carotid arteries are normal in course and caliber. The middle and anterior cerebral arteries are unremarkable. There is minimally decreased central flow related enhancement within the distal basilar artery, possibly representing a tiny fenestration, although the basilar is patent without stenosis. The vertebral arteries and posterior cerebral arteries are normal in course and caliber. There is no evidence of flow-limiting stenosis or aneurysm.
Right parietal lobe hematoma with blood products of various ages, with only mild vasogenic edema. No associated enhancement or abnormal vasculature. Follow up MRI is suggested, as there could be a an underlying lesion obscured by the blood products, such as a cavernoma amongst other possibilities.