34-year-old female with cerebral cavernous malformations. There are 5 lesions within the left cerebral hemisphere which have a "popcorn" appearance of mixed signal characteristics on T1 and T2 weighted images, significant surrounding susceptibility artifact and are mildly enhancing, with T2 hemosiderin rims. The 2 largest are located along the body lateral ventricle and along the deep sylvian fissure. There are 2 smaller lesions in the basal ganglia on the left and a small lesion in the left mesial temporal lobe. There is no T2/FLAIR hyperintensity associated with these lesions. Additionally, there are numerous foci of susceptibility artifact throughout the left frontal and temporal lobes as well as a single focus of susceptibility artifact on the right at the level of the anterior commissure. These foci of susceptibility artifact are not associated with discrete lesions. There are curvilinear, enhancing structures within the left basal ganglia where there is enhancement of dilated medullary veins compatible with at least three discrete DVAs on the left. A right parietal DVA is also present.There is mild volume loss in the left cerebral hemisphere with ex vacuo dilatation of the left lateral ventricle. The cranium is smaller on the left compared to the right indicating that this cerebral atrophy is chronic. There is no evidence of acute intracranial hemorrhage, mass, or acute infarct. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
1.The 5 left cerebral hemisphere lesions are compatible with cerebral cavernous malformations and have evidence of hemosiderin staining from prior microhemorrhage. 2.Additional areas of susceptibility artifact throughout the left frontal and temporal lobe and on the right at the level of the anterior commissure indicate additional areas of hemorrhage that are not associated with visible cavernous malformation.3.Bilateral DVAs as described above.