52-year-old female with history of lupus and head trauma as a child with newly found (but not acutely symptomatic) left homonymous hemianopsia. There is 4 x 6 cm cavitation of the right occipital lobe that communicates with the right occipital horn, compatible with a porencephalic cyst. There is mild T2 hyperintensity in the surrounding white matter. There is also marked thinning and dehiscence of the overlying right occipital calvarium. There is a subcentimeter defect in the right pons. There are also a few punctate foci of white matter T2 hyperintensity in the frontal lobes. There is no abnormal intracranial enhancement. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is no midline shift or herniation. The orbits are unremarkable.
1. Large right occipital lobe porencephalic cyst with mild gliosis and remodeling of the overlying calvarium. 2. A subcentimeter defect in the right pons may represent sequela of a remote lacunar infarct, but no evidence of intracranial hemorrhage, mass, or acute infarct.3. A few punctate foci of white matter T2 hyperintensity in the frontal lobes are nonspecific, but may represent sequela of prior small vessel ischemic disease, perhaps related to lupus vasculitis.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.