Female, 60 years old, with history of metastatic breast cancer, lesion seen in the right cerebellar hemisphere on head CT from 11/30. Post contrast images are degraded by motion artifact. Nevertheless, the finding in the right cerebellum as demonstrated on prior CT is visualized as a smudgy area of enhancement. On review of a prior CT angiogram from 2015, a developmental venous anomaly is evident in this location. There is no edema in the surrounding parenchyma to suggest that this may represent a metastatic lesion.No additional intracranial enhancing lesions are appreciated within the limitation of motion artifact. Parenchymal T2 hyperintensity and encephalomalacia is evident in the right inferior frontal lobe. There is also a slitlike area of encephalomalacia involving the right basal ganglia with mild ex vacuo dilatation of the right frontal horn. Findings are seen compatible with prior right frontal approach instrumentation.No evidence of active parenchymal edema or mass effect is seen. No acute intracranial hemorrhage or any abnormal extra-axial fluid collections are detected. Except as above, the ventricular system is within normal limits. Ectasia and tortuosity of the right proximal MCA were better appreciated on prior studies.
1.Findings in the right cerebellum most likely representing a developmental venous anomaly.2.No definite evidence of intracranial metastatic disease is seen.3.Areas of encephalomalacia involving the right basal ganglia and inferior frontal lobe may reflect prior ischemic disease.