45-year-old female. Reason: 3 t scanner ccm protocol qsm/permiability Known CCMs and DVAs, prior hx of bleeds in 1997, 2008, and 2012. Gamma Knife resection in 2002 of cavernoma. 2008 resection. Second CCM in the L parietal region found in 2012. History: yearly surveillance for ccms Redemonstrated is stable a 7 x 7 mm T2 hypointense, central T1 hyperintense and peripherally T1 hypointense lesion in the posterior left middle temporal gyrus, consistent with a cavernous venous malformation. There is associated blooming on susceptibility weighted imaging. Adjacent prominent vessel, which extends to the margin of the left lateral ventricle, is consistent with an associated developmental venous anomaly. There is no perilesional edemaFocal deformity of the left inferior occipital bone with underlying hemosiderin staining and associated volume loss of the left cerebellar hemisphere, is compatible with prior surgery. There is a resection cavity in the left cerebellum, with associated atrophy of the inferior and middle cerebellar peduncles. There is a prominent associated vessel running posterior and lateral to the resection cavity, which likely represent an associated developmental venous abnormality of the resected cavernoma. These findings are stable in appearance.A tiny developmental venous anomaly is again noted involving the posterior right superior frontal gyrus.There is no restricted diffusion seen to suggest acute infarction. There is mild ex vacuo dilatation of the fourth ventricle; but otherwise, the ventricles and basal cisterns are normal. There is no midline shift or herniation. Few scattered punctate T2 hyperintense foci in the subcortical white matter are nonspecific and stable. Intrinsic T1 hyperintensity in the dentate nuclei are seen bilaterally, likely relating to mineralization.
1.Stable cavernous malformation and developmental venous anomaly in the left posterior temporal lobe. 2.Stable postsurgical changes consistent with reported history of prior cerebral cavernous venous malformation resection in the left cerebellar hemisphere, with probable associated developmental venous anomaly.3.A tiny developmental venous anomaly is again noted involving the posterior right superior frontal gyrus.