Hypertensive emergency [I16.1] / Abnormal findings on diagnostic imaging of skull and head, not elsewhere classified [R93.0], Reason for Study: ^Reason: patient with lesion on head CT that cannot be ruled out as hemorrhage, eval for hemorrhage vs meningioma There is about 8.4 mm sized well-circumscribed lesion of the left with right cerebellar hemisphere. Due to the patient motion artifact, the lesion is not conspicuous on either sagittal T1 weighted image or T2 coronal scan. There is no evidence of associated susceptibility artifacts of the lesion, thus the lesion is unlikely to contain blood products. There is no evidence of associated surrounding edema.Constellation of above findings indicate likely represent such as tentorial based meningioma instead of intra-axial lesion. If clinically indicated, contrast enhanced MRI scan weight the thin section T2 coronal scan can be considered for further imaging evaluation.There is no evidence of acute ischemic lesion.There are multifocal encephalomalacia seen on bilateral basal ganglia.There are scattered bihemispheric multiple susceptibility lesions indicate chronic hemosiderin deposition or parenchymal mineralization.The ventricles, sulci and cisterns are unremarkable. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.
1. About 0.8mm sized well circumscribed lesion overlapped with right cerebellar hemisphere likely represent extra axial lesion such as tentorial meningioma. However, small cerebellar intra axial mass lesion cannot be completely excluded. Gad enhanced MRI with thin section T2 coronal scan can be considered if clinically indicated.2. Multiple encephalomalacia with multifocal parenchymal hemosiderin deposition.3. No evidence of acute ischemic or hemorrhagic lesion.