Hemangioma of intracranial structures [D18.02], Reason for Study: ^Reason: 3T scanner, QSM/permeability, CCM Protocol, had pons hemorrhage in 1982, 2008 began having eye/facial nerve problems, HA, 2016 trouble swallowing, cavernous angioma diagnosed. There is about 15.0mm(RL) x 10.8mm(AP) x 6.7mm(CC) T2 low signal intensity, T1 mainly low signal intensity with susceptibility artifacts on the lower pons indicating likely diagnostic possibility of cavernous malformation. There are evidence of craniotomy on the right temporo occipital bone indicating postoperative status.On Gad enhanced images, There is focal enhancing tubular structure especially on the right anterior aspect of the lesion. The lesion is likely represent associated Developmental venous anomaly, however, other vascular malformations such as associated occult AVM cannot be completely excluded.There is no other abnormal enhancement seen on this scan. The ventricles, sulci and cisterns are symmetric and unremarkable. There is no midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The mastoid air cells are clear. The right maxillary sinus shows subtle T2 high signal intensity and non enhancing low/iso T1 images at the bottom of the sinus cavity which most likely represent partial volume averaging artifact. Other paranasal sinus appear to be normal.
1. Cavernous malformation at the lower pons as described above.2. Tubular enhancing lesion on the right anterior aspect of the lesion indicate associated DVA but the possibility of associated occult AVM cannot be completely excluded.3. No evidence of acute ischemic or hemorrhagic lesion.