Worsening headaches, possible absence seizures, evaluate for change in size of cavernoma. There is a 11 x 11 mm lobulated T2 hyperintense lesion with rim of susceptibility involving the inferior left cerebellar hemisphere abutting the inferior cerebellar vermis. Lesion is consistent with a cavernous malformation and unchanged since 1/8/2015 allowing for differences in technique/slice thickness. There is a prominent developmental venous anomaly in the adjacent left cerebellar hemisphere. There is minimal T1 hyperintensity corresponding to mineralization better seen on prior CT. No findings to suggest recent hemorrhage.Remainder of the brain demonstrates no additional cavernous malformations, or other mass or mass effect. There is mild hypoplasia involving the inferior cerebellar vermis. Brain parenchyma is otherwise unremarkable for age. Bilateral hippocampi are unremarkable. No findings to suggest cortical dysplasia or heterotopic gray matter. No restricted diffusion to suggest acute ischemia. The ventricles are within normal limits in size and configuration. No abnormal parenchymal or meningeal enhancement. MRA images demonstrate no significant stenosis involving the intracranial internal carotid arteries. The middle and anterior cerebral arteries are also patent. The vertebral arteries, basilar artery, and posterior cerebral arteries also are patent with no significant stenosis. Right posterior cerebral artery is predominantly fetal in origin which is a normal variant. No evidence of aneurysms or arteriovenous malformation.Sella and orbits are grossly within normal limits. There is mild mucosal thickening throughout the paranasal sinuses. Bone marrow signal and extracranial soft tissues are within normal limits.
1. Compared to 1/8/2015, unchanged left inferior cerebellar cavernous malformation and adjacent developmental venous anomaly. No findings to suggest recent hemorrhage.2. No other lesions, masses or evidence of mass effect.3. Mild diffuse paranasal sinus opacification which is new since prior.