Congenital malformation of circulatory system, unspecified [Q28.9], Reason for Study: ^Reason: evaluate for vascular malformation History: headache; history of vascular malformation Brain MRI:There is no evidence of acute ischemic or hemorrhagic lesion on the scan. There is no abnormal enhancing lesion intracranially.There is a however 10.5 mm x 17.9 mm sized well circumscribed ovoid enhancing lesion on the left anterior aspect of temporalis muscle. The lesion showed high signal intensity on T2 weighted image and iso signal intensity on T1 weighted image. The lesion shows internal susceptibility artifacts on gradient echo images. The MR findings of this lesion suggest possible venous vascular malformation or hemangioma.The cerebellar tonsils are low lying through the foramen magnum about 6mm. No evidence of syrinx. The ventricles, sulci and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The mastoid air cells are clear. There is mucosal thickening on the right maxillary sinus.Neck MRI:There are multiple variable sized lesions showing high signal intensity on T2, lower or iso signal intensity comparing to adjacent muscle on T1 with evidence of Gad enhancement. The lesions are located on bilateral anterior aspects of tongue (series 1501, image 24 and 27) and anterior aspect of the right SCM muscle at the level of vocal cord (series 1501, image 32). Based on MR signal characteristics, these lesions are likely represent venous vascular malformation. Otherwise oro.nasopharynx, hypopharynx, larynx and subglottic airways are unremarkable. The epiglottis, vallecula, piriform sinuses, and vocal cords are normal. The parotid, submandibular, and thyroid glands are unremarkable. The carotid arteries and jugular veins are patent.
1. No evidence of acute ischemic or hemorrhagic lesion of brain.2. No evidence of intracranial vascular lesion on this scan.3. Low lying cerebellar tonsils about 6mm through the foramen magnum. 4. Multifocal lesions with high signal intensity on T2, low or iso signal intensity on T1 with evidence of Gad enhancement on left anterior aspect of temporalis muscle, bilateral anterior aspect of tongue and anterior aspect of the right SCM muscle at the level of vocal cord indicating possible venous vascular malformation. 