33 years Female (DOB:9/1/1982)Reason: CCM yearly surveillance History: yearly surveillancePROVIDER/ATTENDING NAME: ISSAM A. AWAD ISSAM A. AWAD The CSF spaces are appropriate for the patient's stated age with no midline shift. A small focus of signal loss is present in the left paracentral lobule adjacent to the marginal ramus of the cingulate sulcus measuring several millimeters in size. It appears be associated with a very small developmental venous anomaly. It is unchanged since the prior exam.Multiple foci of signal loss and susceptibility weighted imaging are present with the lesions identified in the subcortical white matter of the frontal lobes, parietal lobes and right cerebellar hemisphere. No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.A lesion in the left paracentral lobule suspicious for a cerebral cavernous malformation is stable compared to the prior exam.2.There are multiple punctate lesions in the subcortical white matter which were also present on the prior exam and are nonspecific and too small to characterize further. It is conceivable that these are related to cavernoma or microhemorrhages from other cause.