Evaluate for occipital lobe encephalomalacia. New presentation of seizures. There is redemonstration of encephalomalacia involving the left occipital cortex with underlying hemosiderin deposition identified on prior MRI. There is a mildly dilated abnormal venous structure coursing along the lateral margin of this encephalomalacia which drains into a subependymal vein as well as a superficial cortical vein. No discrete mass or abnormal parenchymal or meningeal enhancement is seen in the brain. There is no clear evidence of a nidus to suggest arteriovenous malformation.
Examination limited to post contrast sequences. Again seen is encephalomalacia in the left occipital cortex with evidence of chronic hemorrhage in this region on earlier MRI. There is an abnormally dilated venous structure which courses through this area of encephalomalacia. There is no clear nidus to suggest arteriovenous malformation, although this possibility can be better excluded with conventional angiography if clinically warranted. There is a possibility that the venous structure represents a developmental venous anomaly associated with a cavernous malformation, which is not well delineated amidst the hemosiderin deposition.