Epilepsy. Six-month follow-up of cavernous malformation. There is a non-enhancing focus of susceptibility effect in the left anterior frontal lobe, within the deep white matter of the superior frontal gyrus, that measures up to 7 mm. There is no appreciable associated vasogenic edema and this has not changed since the previous examinations. There is an unchanged, contrast enhancing lesion with serpentine susceptibility effect involving the lingual sulcus (likely extraparenchymal) in the anteromedial left occipital lobe that measures up to 20 mm. In addition, there is a focus of brush-like enhancement and susceptibility effect in the right pons that measures up to 3 mm. This also has not changed. There is no evidence of acute intracranial hemorrhage or acute cerebral infarct. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The subcentimeter cystic lesion along the lateral aspect of the left mandibular condyle is stable, possibly representing a synovial cyst.
1. Subcentimeter lesion in the left frontal lobe likely represents a cavernous malformation, without evidence of acute hemorrhage.2. An enhancing lesion involving the left lingual sulcus (extraparenchymal), centered in the anterior occipital lobe, may also represent a type of vascular malformation. A dedicated MRA or CTA may be useful for further evaluation.3. A punctate enhancing lesion in the right pons is compatible with a capillary telangiectasia.4. These lesions are unchanged compared to the examinations of April and January 2015.