 There is an approximately 10 mm AP x 6 mm craniocaudal x 8 mm transverse nonenhancing lesion centered along the leftward aspect of the foramen of Monroe. This is isointense on T1 with mixed intensity on T2 (comprised of central hypointensity and peripheral hyperintensity, the so-called "black hole" effect). Ventricular sizes remain normal without evidence of obstructive hydrocephalus at this time.There are scattered punctate foci of T2 hyperintensity primarily within subcortical white matter without associated mass effect, restricted diffusion, susceptibility abnormality, or for enhancement. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. The pituitary gland is normal in size. There is no evidence for intracranial hemorrhage or acute cerebral, brainstem or cerebellar infarction. No diffusion-weighted abnormalities are identified. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. The paranasal sinuses and mastoid air cells are clear. A small amount of mucosal thickening is noted within an aerated right petrous apex air cell. There is no abnormal enhancement within the brain.
1.MRI findings consistent with a colloid cyst along the leftward aspect of the foramen of Monroe. Ventricular sizes remain normal without evidence of obstructive hydrocephalus at this time. Recommendations are made to consult neurosurgery.2.Mild chronic small vessel ischemic disease.