Reason: 3T Scanner, CCM disease with recent hemorrhage, 2-3 month follow up, please compare to prior scan History: Surveillance There is redomonstration of a focus of susceptibility effect now present in the left precuneus which has changed signal characteristics and size since the prior exam. There is no T2/FLAIR signal hyperintensity associate with the lesion on the current exam. On the prior exam it measured 11 x 11 mm coronal dimensions and on the current it measures 10x8mm coronal dimensions.There is a small hemorrhagic lesion present in the right cuneus which is stable compared to the prior exam.There is redemonstration of a small left-sided thalamic lesion which has a central signal hyperintensity on T2 and the surrounding susceptibility effect. When compared to the prior exam and appear stable.There is redemonstration of punctate focus of susceptibility at the left pons which is also stable and compared to the prior examThere is redemonstration of a punctate foci of susceptibility in the right middle frontal gyrus, left inferior parietal lobule, right medial temporal lobe, right frontal subcortical white matter and right lateral temporal lobe all of which were also identified on the prior exam on susceptibility imaging but not routine imaging.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 are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.There is redemonstration and no change in a hemorrhagic lesion in the right cuneus. The possibility that this represents cerebral cavernous malformations cannot be excluded.2.A hemorrhagic lesion, in the left precuneus has decreased in size and evolved since the prior exam. The possibility that this represents cerebral cavernous malformations cannot be excluded.3.There is redemonstration of a left thalamic hemorrhagic lesion which is stable and compared to prior exam . This compatible with the patient's diagnosis of cerebral cavernous malformation.4.There is redemonstration of multiple punctate lesions in the pons as well as the supratentorial brain as described above. Please correlate with the patient's clinical history for possible familial cerebral cavernous malformations.