Male, 4 years old, with new onset episodic headache and emesis. A 6 x 5 x 5 mm slightly lobular, intraparenchymal T2 hyperintense lesion is evident just medial to the right occipital horn. The lesion is mildly T1 hypointense, but induces strong susceptibility artifact. No definite associated edema or mass effect is seen.No additional parenchymal lesions are seen. Brain morphology is within normal limits. No areas of edema or mass effect are detected. No diffusion restricting lesions are present. There are no findings to suggest acute intracranial hemorrhage or any abnormal extra axial fluid collection. The ventricles are normal in size and morphology.The region of the pituitary is unremarkable. The brainstem, cerebellar vermis and cerebellar hemispheres are unremarkable. The corpus callosum is fully formed and intact. The pattern of myelination is mature.
A subcentimeter, slightly lobular, intraparenchymal T2 hyperintense lesion is evident just medial to the right occipital horn. The lesion induces strong susceptibility effect which may represent hemosiderin deposition or mineralization.Lack of associated edema or mass effect is reassuring for a benign etiology, and this may in fact be an incidental finding unrelated to the patient's presenting symptoms. Likely differential considerations would include a cavernous malformation or small area of gliosis/hemosiderin staining from a prior insult. A follow-up examination with contrast can be considered in 6-12 months.