57-year-old female with known CCM disease including bleeding in July 2015, and prior history of resection in 2007. There are innumerable areas of low signal intensity on susceptibility-weighted sequences of varying sizes within the bilateral cerebral hemispheres as well as brainstem and cerebellum consistent with cavernous malformations. There is a large lesion within the left posterior frontal lobe abutting the frontal horn of the left lateral ventricle measuring 3.2 cm x 3.1 cm (series 701, image 19) which demonstrates internal T1 hyperintensity which may be related to recent hemorrhage. An additional lesion within the medial right temporal lobe measures 2.3 cm x 2.0 cm (series 701, image 11) demonstrates similar signal intensity pattern. There is no surrounding edema associated with these lesions. There is also hemosiderin staining involving the left pre- and postcentral gyri likely related to prior rupture of a cavernous malformation. There is evidence of prior resection within the right parietal lobe. There is no evidence of infarct. No midline shift or herniation. No hydrocephalus.Partial opacification of the right maxillary sinus, anterior ethmoid air cells and sphenoid sinuses. The orbits are unremarkable.
1. Numerous cavernous malformations throughout the brain. The largest lesions involving the left posterior frontal periventricular region and the right medial temporal lobe demonstrate T1 hyperintensity which may be related to more recent hemorrhage. There is also hemosiderin staining involving the left pre and postcentral gyri likely related to prior ruptured cavernous malformation. No edema is associated with the lesions. No prior studies are available for comparison, and if made available, an addendum can be issued.2. Postsurgical changes in the right parietal lobe presumably related to prior cavernous malformation resection.