Diagnosis: Hemangioma of intracranial structuresClinical question: Please evaluate cavernomas for changes, 3T Scanner, QSM/Permeability, CCM Protocol. Please compare to outside scan from July.Signs and Symptoms: Brainstem cavernomas, worsening vision, gait in recent months since last MRIComments: Please evaluate cavernomas for changes, 3T Scanner, QSM/Permeability, CCM There is redemonstration of a 10 x 6 mm lesion in the right pons associated with heterogeneous signal on T2 and T1 and a popcorn-like appearance on T2. There is some associated contrast enhancement.There is a redemonstration of a heterogeneous lesion with susceptibility effect present in the left midbrain along the tectal plate which measures 10 x 7 mm axial dimensions and previously measured similar dimensions there is redemonstration of T2 signal hyperintensity along the anterior lateral aspects of the medulla bilaterally. There is some associated contrast enhancement.There is a developmental venous anomaly present along the pons.On susceptibility weighted imaging there is a punctate focus of signal loss in the medial aspect of the left occipital lobe.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.Redemonstration of a pontine and midbrain cerebral cavernous hemangiomas associated with an adjacent developmental venous anomaly.2.Some signal changes in the medulla are present which are nonspecific. Stable since the prior exam and could be reactive to the above lesions.