Clinical question: History of thalamic abscess in the outside hospital. Evaluate resolution. Signs and symptoms: None surveillance scan. Pre-and post-enhanced brain MRI:Unremarkable diffusion weighted series.Examination demonstrates a focus of susceptibility signal change in the right thalamus with hypointensity signal pattern on both flair and T2-weighted images. The finding demonstrate increased T1 hyperintensity and findings are suggestive of a focus of chronic hemorrhage. There is no evidence of surrounding edema or any appreciable mass effect. A thin band of encephalomalacia/gliosis extends from this finding laterally and superiorly to the inner table of the skull in the right posterior frontal and consistent with a surgical tract from prior operation.Post enhanced images demonstrate no enhancement to suggest presence of an infectious process. There are however small linear vascular enhancement within this region which are contiguous with prominent right thalamic. The appearance of the finding is suggestive of a cavernous malformation or a developmental venous anomaly. There are no prior exams for comparison. If such exams are available and are provided the radiology department an addendum to this report was resubmitted after comparison. The findings on this exam are not suggestive of a prior infection/abscess at this site. Comparison to prior exams is important for clarification and is highly recommended. Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and brain myelination otherwise stated age.The signal void of major intracranial arterial branches are identified.The signal intensity of intracranial venous sinuses are within normal and with normal pattern of enhancement.Unremarkable calvarial, orbit, paranasal sinuses and mastoid air cells.
1.No diffusion weighted abnormalities.2.Focus of susceptibility signal change in the right thalamus with internal linear vascular (likely venous) enhancement contiguous with a slightly prominent right thalamic vein as detailed above. Constellation of signal changes and pattern of enhancement is highly suggestive of a cavernous malformation with an associated developmental venous anomaly.3.There is no finding on this exam to suggest presence of an infectious or inflammatory process.4.Unremarkable pre-and post enhanced brain MRI otherwise.5.Expected signal changes along the surgical tract from a right frontal burr hole approach.6.Comparison with prior exams are highly recommended considering provided clinical history of right thalamic abscess which does not correlate with any findings on this exam. Please see above comments.