Female, 27 years old, history of cerebral cavernous malformation status post craniotomy for lesion resection. Surveillance scan. Findings are seen compatible with prior right temporal craniotomy appearing similar to prior exams.A 9 x 5 mm somewhat wedge-shaped parenchymal defect is evident within the right pons just below the cerebral peduncle. Several foci of susceptibility are evident within or around this defect. No pathologic enhancement is seen. The appearance of this abnormality has not significantly changed over multiple prior exams.Within the left subinsular white matter, just anterior to the basal ganglia, an oval 9 x 8 mm lesion is evident showing rim hemosiderin staining and mildly increased T1/T2 signal internally. This lesion has not significantly changed from prior exams. No definite associated enhancement or obvious pathologic vasculature is demonstrated.Several small foci of susceptibility are evident scattered around the cerebral hemispheres including within the right superior frontal gyrus, more inferiorly in the right centrum semiovale, within the left inferolateral thalamus and in both temporal lobes. No additional convincing signal abnormality is evident at these locations on the other MR sequences. Some but not all of these foci were visualized on prior exams though this may be related to differences in technique.A developmental venous anomaly is suspected within the left precentral gyrus. Otherwise, no pathologic enhancement is evident on this examination.No parenchymal edema or mass effect is seen. No abnormal extra-axial collections are detected. The ventricles are normal in size and morphology.
1.A small parenchymal defect is evident within the right pons which may be postoperative in nature given evidence of prior craniotomy. Correlation with surgical history is suggested. In any event, this finding has not significantly changed dating back to 2008.2.A lesion within the left subinsular white matter is identified with imaging features compatible with a cavernous malformation. No definite associated DVA is seen. Again, this lesion has not substantially changed dating back to 2008.3.A developmental venous anomaly is seen within the left precentral gyrus, but no other associated abnormalities are detected.4.Scattered small foci of susceptibility within the cerebral hemispheres are nonspecific given lack of any other associated signal abnormality.