Reason: on 3T Scanner, known paraclinoid ICA aneurysm History: Surveillance MRI of the brainThere is an 8 x 5 mm axial dimension left cerebellar lesion which is heterogeneous but mainly low signal on T2WI and mainly hypointense on T1WI, associated with susceptibility effect and an adjacent developmental venous anomaly. This appears to be stable since the prior exam.There is a punctate focus of susceptibility effect present at the right posterior temporal lobe it is best seen on the susceptibility images and not readily appreciated on the flair or T2 images. It is unchanged since prior exam.There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.No diffusion restriction is appreciated.The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.No 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 are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.MRA brain:There is a 3-mm aneurysm along the left internal carotid artery. It is a paraclinoid aneurysm. It is stable compared to the previous exam.Antegrade flow is present in the distal internal carotid arteries, the distal vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries.There is no evidence for intracranial aneurysm or cerebrovascular occlusion.The anterior communicating artery is identified. There is fetal origin of the right posterior cerebral artery with a hypoplastic right P1 segment. The left posterior communicating artery is small. The anterior communicating artery is small. The vertebral arteries are similar in size.
1.Findings are compatible with a small sporadic cavernous malformation in the left cerebellar hemisphere.2.A left paraclinoid aneurysm along the internal credit artery is stable3.A punctate microhemorrhage in the right temporal lobe and isolation is of unknown clinical significance. It is unchanged since prior exam.4.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related. 5.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related. 