Reason: change in MRI abnormality History: pulsatile tinnitus There is been no interval appreciable change in appearance or extent of abnormal ill-defined T2/FLAIR hyperintensity in the left parietal centrum semiovale extending into the left periatrial and subcortical white matter towards the vertex. There is no corresponding enhancement or susceptibility. There is no associated mass effect.The previously noted punctate focus of hyperintensity in the right orbital gyrus is not as well visualized but appears grossly unchanged. There are no new areas of parenchymal signal abnormality. Again noted is prominence of the paramedian extra-axial space along the posterior fossa which may represent a retrocerebellar cyst or mega-cisterna magna. There is mild associated splaying of the cerebellar hemispheres.Again noted is a 5 mm triangular shaped focus of enhancement along the left cerebellopontine angle cistern adjacent to the petrosal vein which remains unchanged. There remains prominent diffuse paranasal sinus disease, in similar pattern to previous exams.
1. Continued stable appearance of nonenhancing ill-defined T2/FLAIR hyperintense lesion in the left high parietal lobe with unchanged differential. Continued follow-up is recommended to exclude the possibility of low-grade neoplasm.2. Stable triangle shaped enhancing structure along the left cerebellopontine angle cistern which represent a focally dilated vascular structure, most likely venous.