Reason: r/o CCM History: tremors The CSF spaces are appropriate for the patient's stated age with no midline shift. There is redemonstration of a small focus of susceptibility effect adjacent to the left medial longitudinal fasciculus which is unchanged compared to the prior exam. There is associated contrast enhancement which is stable compared to the prior exam. There is redemonstration of adjacent draining veins.A stellate focus of susceptibility is present the periventricular white matter adjacent to the frontal horn of the left lateral ventricle which is associated with developmental venous anomaly. It is also stable compared to the previous exam. There is associated enhancement.A small developmental venous anomaly is present along the inferior aspect of the left cerebral hemisphere.No abnormal enhancing 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 are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.A small left pontine hemorrhagic lesion is stable compared to the prior exam. One possibility is that this represents capillary telangiectasia.2.Left frontal periventricular white matter lesion most likely represents developmental venous anomaly associated with capillary telangiectasia.