Female, 65 years old, with hereditary hemorrhagic telangiectasia, known meningioma seen several years ago on outside imaging, prior angio embolization for nosebleeds, evaluate for AVMs and for known meningioma. Scattered small foci of periventricular and subcortical T2 hyperintensity are seen, slightly increased in number from prior examinations. No evidence of restricted diffusion is seen. No edema or mass effect is detected.A 10 mm enhancing extra-axial mass is seen along the left paramedian convexity partially involving the adjacent marrow. This lesion exerts no significant mass effect on underlying brain. There has been no significant interval change in size compared to prior exams.No additional enhancing lesions are seen. No intracranial hemorrhage or any abnormal extra-axial fluid collection is seen. The ventricles are normal in size and morphology.The anterior nasal septum is deficient and the posterior nasal septum is thickened, findings which have not significantly changed from prior. The ostiomeatal units are deficient which may be postoperative. Mucosal thickening is seen along the maxillary sinus floors, left side more than right.No evidence of an arteriovenous malformation, capillary telangiectasia, or other vascular malformation is seen. No significant vascular stenosis or occlusion is detected. Early branching of the right M1 MCA is a normal variant.
1.A small left convexity meningioma is unchanged.2.No evidence of any AVM, capillary telangiectasia or other intracranial vascular malformation is seen. 3.The MRA examination is within normal limits.4.Scattered foci of white matter signal abnormalilty are nonspecific but likely represent chronic small vessel ischemic disease. 5.Deficiency of the anterior nasal septum may be post-operative or related to prior embolization. There is evidence of sinus mucosal inflammation and likely prior sinus surgery.