76 years Male (DOB:5/14/1940)Reason: follow up the cavernoma, right temporal region. History: epilepsyPROVIDER/ATTENDING NAME: SHASHA WU SHASHA WU The CSF spaces are appropriate for the patient's stated age with no midline shift. There is redemonstration of a 14x9 mm axial dimension (on T2) lesion which is hypointense peripherally and has a popcorn-like appearance on T2 imaging located in the right inferior parietal lobule which was also present on the prior exam. Since the previous exam from 7/7/2010 there is a little bit more low signal on the medial aspect of the lesion when compared to the prior exam. Otherwise the lesion has not changed substantially. There is associated blooming artifact. On susceptibility weighted imaging there is a punctate millimeter size lesion located adjacent and above the occipital horn of the left lateral ventricle which can also be subtly seen on FLAIR MRI images on the current exam but not readily appreciated on the prior examThere is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images. These have accumulated more on the left hemisphere relative to the right and are more numerous on the current exam versus the prior examNo abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.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 demonstrate a mucous retention cyst in the left maxillary sinus. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.Stable right inferior parietal lobule cavernoma.2.Since the prior exam patient has developed a millimeter size hemorrhagic focus in the left occipital lobe adjacent and above the occipital horn of the left lateral ventricle.3.Since prior exam the patient has accumulated more periventricular white matter lesions in the left hemisphere predominantly. At this age these are most likely vascular related.