19 years Male (DOB:6/4/1997)Reason: CCM Protocol/QSM/permeability 3T scanner, please evaluate known lesion (CCM?) History: SeizuresPROVIDER/ATTENDING NAME: ISSAM A. AWAD ISSAM A. AWAD The CSF spaces are appropriate for the patient's stated age with no midline shift. Some of the imaging is degraded due to patient motion artifact.There is a hemorrhagic focus present along the medial aspect of the left temporal lobe which is associated with some surrounding T2 signal hyperintensity. It measures approximately 6 by 4mm. It can also be identified on the susceptibility weighted imaging on the prior exam as well. On FLAIR imaging it appears stable relative to the prior exam. It is associated with some ill-defined enhancement along the medial aspect of the left temporal lobeNormal 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 mild mucosal thickening in the right maxillary sinus which was also present on the prior exam. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.There is a hemorrhagic lesion present in the medial aspect of the left temporal lobe. This appears stable and compared to the January exam. Although not classic in appearance cerebral cavernous malformation is a differential consideration. Other entities such as neoplasm cannot be entirely excluded based on this exam alone. Given the lack of interval change in an inflammatory/infectious focus is less likely.