54 years Male (DOB:2/12/1962)Reason: central explanation for pain History: UE and LE weakness, pain, and locking symptomsPROVIDER/ATTENDING NAME: JAMES A MASTRIANNI JAMES A MASTRIANNI There is a 28 mm with x 16 mm x 33 mm peripherally enhancing septated cystic type lesion within the occipital bone just behind the superior sagittal sinus at the level of the right occipital sulcus associated with focal calvarial thickening. There is some adjacent marrow replacement present. There is no associated diffusion restriction. There is associated bony remodeling.There is a perforation present along the calvarium along the midline associated with the venous drainage and suspected communication superior sagittal sinus..No mass lesions are identified in brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrate mild mucosal thickening. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.There is a lesion within the midline of the occipital calvarium present at the midline. It is not certain what this represents. One possibility is that this may represent an arachnoid granulation. It is not clear what this represents. A follow- up exam may be helpful. CT may help further characterize it. 2.There is a fenestration along the midline at the junction of the parietal bones which appears to be associated with sinus pericranii. This can be confirmed with CTV.3.No brain lesions are identified to explain the patient's symptoms.