54 years Female (DOB:5/3/1962)Reason: 3 t scanner ccm protocol qsm permeability History: headaches evaluate for aneurysmPROVIDER/ATTENDING NAME: ISSAM A. AWAD ISSAM A. AWAD There is a serpiginous lesion present along the junction of the left lingual gyrus, fusiform gyrus and left parahippocampal gyrus and within the left collateral sulcus which extends to the periventricular white matter at the temporal horn which is low signal on T2 and associated with susceptibility effect. There is associated contrast enhancement with this lesion extending from the subarachnoid space into the gyrus. Associated with a somewhat caput medusa appearance. There is a CT from 4/7/2 6003 which suggested this was smaller at that time.There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.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.
Lesion present within the left collateral sulcus and adjacent brain parenchyma is present which could represent a developmental venous anomaly associated with venous varix or small cavernoma. A coincidental small extra-axial mass such as a meningioma along the tentorium cannot be excluded. A follow-up exam would help further evaluate for this possibility.