7 years, Male, cerebral cavernous malformation There is a 10 x 15 x 16 mm lesion in the right frontal lobe involving the cingulate gyrus and to a mild extent, body of the corpus callosum, with heterogeneous T1 and T2 hyperintensity and rim of susceptibility consistent with cavernous malformation. There is an additional relatively more prominent lesion involving the cortex and subcortical white matter in the left parietal lobe measuring approximately 12 mm in diameter, measured on the axial T2-weighted sequence. There are at least 10 additional lesions which are smaller and scattered throughout the bilateral cerebral hemispheres as well as in the right cerebellar hemisphere. There is no significant intracranial mass effect, midline shift, or herniation. Ventricles and sulci are within normal limits aside from nonspecific mild asymmetric enlargement of the right lateral ventricle and minimal contour deformity involving the superior aspect of the right lateral ventricle related to minimal local mass effect associated with the right cingulate gyrus lesion. No evidence of hydrocephalus.Postgadolinium images are significantly motion degraded but are grossly unremarkable. Major flow-voids are preserved indicating patency of the major intracranial vasculature. Borderline low cerebellar tonsils are incidentally noted measuring approximately 5 mm below the foramen magnum without significant crowding at the foramen magnum. Brain parenchyma is otherwise unremarkable.There is a partially empty sella which is nonspecific. Paranasal sinuses and mastoid air cells are grossly clear. Calvarium and remainder of the extracranial soft tissues are unremarkable.
1. Multiple cerebral cavernous malformations in the bilateral cerebral and right cerebellar hemispheres as described above. The largest lesion is centered in the right cingulate gyrus and demonstrates heterogeneous T1 signal, which may indicate relatively recent hemorrhage although there is no surrounding edema to support this finding. No prior studies are available for comparison, and addendum can be issued if made available.2. Borderline low cerebellar tonsils are incidentally noted. There is also a partially empty sella which can be normal variant or associated with intracranial hypertension in the appropriate clinical setting.