VHL disease and cocaine abuse evaluate for possible brain aneurysm. MRI: There are postoperative findings in the right posterior fossa, with confluent high T2 signal surrounding the right cerebellar hemisphere a mildly T2-FLAIR hyperintense cavity that measures up to 20 mm with a small mural nodule. There is scattered cerebral white matter T2 hyperintensity. There is no evidence of acute intracranial hemorrhage or acute infarct. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The orbits are grossly unremarkable.MRA: There is no evidence of aneurysms or significant steno-occlusive lesions.
1. Postoperative findings in the right cerebellar hemisphere, with what likely represents a hemangioblastoma. Assessment is otherwise limited without intravenous contrast.2. Scattered cerebral white matter T2 hyperintensity may represent chronic small vessel ischemic disease, but no evidence of acute infarct.3. No evidence of cerebral aneurysms.