Familial cerebral cavernous malformation. Brain: The supratentorial and infratentorial cavernous malformations have not appreciable changed. There is no associated edema or acute infarction. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are unchanged.Cervical spine: There is a 1 cm diameter cavernous malformation in the spinal cord at the C2 level with associated surrounding T2 hypointensity, which appears to have slightly increased in extent. There is no other cervical spinal cord intramedullary lesion. There are postoperative findings related to previous C1-C3 posterior decompression via laminectomies. There is reversal of the normal lordosis, centered at C3-C4. There is also minimal anterior subluxation of C3 relative to C4 and C2 relative to C3. There is loss of disc T2 signal from C2 through C7 associated with minimal disc height loss and bulges. The vertebral bodies are preserved in height. The vertebral bone marrow signal is also unremarkable. There is no significant spinal canal or neural foraminal stenosis.
1.The punctate cerebral and brainstem cavernous malformations are not significantly changed since May 2015.2.Increased chronic hemorrhage surrounding the upper cervical spinal cord cavernous malformation since August 2014. 3.Postoperative findings related to C1-C3 posterior decompressive laminectomies with persistent reversal of the normal cervical lordosis centered at C3-C4 and slightly more pronounced upper cervical subluxations.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.