Right base of skull mass. MRI: There is an unchanged lesion with high T2 and low T1 signal involving the right petrous apex and basiclivus. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There are unchanged T2 hyperintense foci within the cerebral white matter and foci of susceptibility effect that may represent chronic microhemorrhages. There is also unchanged encephalomalacia with hemosiderin lining in the medial left temporal lobe. There is a partially-empty sella. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits paranasal sinuses, and scalp soft tissues are grossly unremarkable.MRA: There is an unchanged left MCA bifurcation aneurysm measuring approximately 3 x 2 mm and a right PCOM aneurysm measuring approximately 3 x 2 mm. There are no new cerebral aneurysms or significant steno-occlusive lesions.
1. Unchanged lesion within the right petrous apex and basiclivus for which the differential diagnosis includes trapped secretions and less likely neoplasm, such as low grade chondrosarcoma. 2. Unchanged subcentimeter cerebral aneurysms.3. Unchanged probable microangiopathic white matter disease and hypertensive microhemorrhages, as well as left medial temporal lobe encephalomalacia.