Diagnosis: Hemangioma of intracranial structuresDiagnosis Edits: Clinical question: 3T Scanner, QSM/Permeability, CCM Protocol, please evaluate for changesSigns and Symptoms: loss of bowel control, new dizziness and trouble speakingComments: 3T Scanner, QSM/Permeability, CCM Protocol, please evaluate for changes | There is redemonstration of a hemorrhagic lesion centered in the left pons but also involving the left middle cerebellar peduncle which is not changed substantially in dimensions. It currently measures 25 x 45 mm and previously measured the same. When compared to the 9/14/2015 exam signal characteristics within the lesion have a changed slightly especially along the left pontine cystic lesion which previously had a more heterogeneous signal in the size and more cystic signal. A hemorrhagic lesion within the right cerebral peduncle and another one in the left upper posterior midbrain are also stable.A high signal intensity lesion on T2 imaging in the left medulla remains stable.There is a developmental venous anomaly redemonstrated in the left cerebellar hemisphere inferiorly.The patient is status post suboccipital craniotomy.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 demonstrate a mucous retention cyst in the left maxillary sinus as well as minor opacities in the left ethmoid air cells.. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.There is redemonstration of multiple cerebral cavernous malformations in the brainstem and cerebellum associated with a left cerebellar developmental venous anomaly. Although the dimensions are relatively stable the associated blood products continue to evolve.2.Status post posterior fossa surgery.