Reason: 57 y.o. h/o of cerebral History: 57 y.o. female with known hx of cerebral aneurysm. Noted @ an outside clinic surveillance. Pt has a hx of htn, "brain tumor" that is being monitored, "brain aneurysm" that has required no intervention, and l ureteral stone diagnosed in 9/14 s/p stent and subsequent stent removal. The CSF spaces are appropriate for the patient's stated age with no midline shift. There is an homogeneously enhancing, well circumscribed 10x12mm mass located in the right occipital pole posteriorly involving the gray matter more than the white matter. The cerebellar tonsils are low lying extending 8 mm below the level of foramen magnum. The cerebellar tonsils are pointed inferiorly. There is associated marked syrinx in the visualized portions of the cervical spinal cord measuring approximately 10 mm in diameter.No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.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.Incidental note is made of partial empty sella.
1.There is a small cortically based right occipital lobe mass present. Differential considerations include primary brain tumor such as galnglioglioma as well as metastasis and lymphoma.2.There is a Chiari one malformation present associated with a spinal cord syrinx. The ventricles do not appear enlarged.3.If there is clinical concern for a cerebral aneurysm, an MRA of the brain would be more sensitive in its evaluation relative to MRI.