Diagnosis: Disorder of brain, unspecifiedClinical question: cerebellar brain lesion, 6 months follow up , evaluate for changes or growth.Signs and Symptoms: projectile vomiting, brain lesion The CSF spaces are appropriate for the patient's stated age with no midline shift. There is redemonstration of a well-circumscribed 9 x 7 mm coronal dimension lesion along the left posterior aspect of the medulla. It is bright signal on FLAIR and T2 MRI and has lower T1 signal when compared to the adjacent brain tissues and is not associated with susceptibility effect. It is associated with enhancement following gadolinium administration, however, there appears to be a more cystic component surrounding a mural nodule. It does have some local mass effect. It has not changed in size or signal characteristics when compared to the prior examNormal 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.
A small mass with a cyst and mural nodule appearance located along the left posterior lateral aspect of the medulla is stable when compared to previous exams. Stability suggests that it is not aggressive. Differential considerations do include neoplasm however, and infection such as cysticercosis in the appropriate clinical setting, may have a cystic mural nodule appearance though would be expected to evolve over time.