Left parietal lesion and right pulsatile tinnitus. MRI: There is an unchanged subcentimeter globular enhancing focus in the left cerebellopontine angle cistern that appears to be continuous with the left petrosal sinus. There is an unchanged non-enhancing patchy area of white matter T2 hyperintensity in the left parietal lobe with blurring of the grey-white matter junction. There is no evidence of intracranial hemorrhage or acute infarct. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, and scalp soft tissues are grossly unremarkable. There is moderate scattered paranasal sinus mucosal thickening.MRA: There is no evidence of significant steno-occlusive lesions or arteriovenous malformations.
1. Unchanged left parietal lobe lesions may represent focal cortical dysplasia, sequela of prior injury, and perhaps less likely neoplasm, for example.2. Subcentimeter left cerebellopontine angle varix versus less likely an aneurysm. Otherwise, no evidence of cerebral significant steno-occlusive lesions or arteriovenous malformation, within the limits of the modality.3. Scattered paranasal sinus mucosal inflammatory disease.