Female, 78 years old, with metastatic melanoma, screening examination for brain metastases. A 2 mm focus of enhancement is seen within the left inferior cerebellum. There is no associated T2 signal abnormality or edema.A small developmental venous anomaly is evident within the right postcentral gyrus. No additional pathologic intracranial enhancement is observed.No restricted diffusion is seen. Numerous scattered foci of periventricular and subcortical FLAIR hyperintensity are demonstrated without edema or mass effect.No findings are seen to suggest intracranial hemorrhage or any abnormal extra axial fluid collections. The ventricles are normal in size and morphology.Opacification of the sphenoid sinuses is demonstrated.
1.A 2 mm focus of enhancement is evident within the left inferior cerebellum. As this is the only pathologic intracranial enhancement detected, the finding is nonspecific but metastatic disease would be in the differential diagnosis. Close interval follow-up should be considered.2.Evidence of chronic microvascular ischemia is seen.