 BRAIN: The enhancing focus in the left midbrain is again seen and is hyperintense on T1, heterogeneous with a hypointense rim on T2, and demonstrates blooming artifact on susceptibility weighted images. This lesion measures 6 x 5 mm, previously 6 mm. There is no adjacent mass effect or FLAIR signal to indicate edema.Additional curvilinear enhancement in the inferior right frontal gyrus extends to a focus of susceptibility artifact which was present on prior examinations but now demonstrates blooming artifact. There is no adjacent mass effect or FLAIR signal to indicate edema. This is likely a developmental venous anomaly with a small associated cavernoma which has bled in the interval from 12/2014.Focal dural thickening adjacent to the left middle frontal gyrus demonstrates enhancement and is not significantly changed from the prior examinations.There is susceptibility artifact along the anterior cranial fossa bilaterally which, although there is no CT to correlate, may represent mineralization of the dura. An additional, questionable small round focus of susceptibility is noted near the cerebral vertex which is nonspecific but may represent a small cavernoma or possible focus of mineralization.There are no new enhancing masses. There is no diffusion abnormality to suggest acute infarct. Prominent left choroid is unchanged. The ventricles and sulci are within normal limits. The major intracranial vascular structures enhance normally.NECK: The fat saturation portions of this examination are inhomogeneous, slightly limiting evaluation. There are postoperative changes related to thyroid isthmusectomy and neck dissection with susceptibility artifact from surgical clips. There is no evidence of recurrent tumor in the thyroid bed. No nasopharyngeal mass is identified. There is no significant lymphadenopathy.The salivary glands appear normal. The parapharyngeal soft tissues appear normal. The larynx appears normal. Flow voids are noted in the major cervical vasculature. The marrow signal of the cervical and upper thoracic vertebrae is normal. Area of fan-like opacity in the left upper lobe corresponds to areas of ground glass opacity seen on CT from 3/18/15.
1.Stable lesion in the left midbrain, compatible with cavernoma.2.Likely developmental venous anomaly with associated cavernoma in the right frontal lobe with interval hemorrhage since 12/10/14 but no edema.3.Probable left frontal meningioma stable.4.Postoperative findings of thyroid isthmusectomy and neck dissection without recurrence or lymphadenopathy.5.No evidence of recurrent nasopharyngeal carcinoma or lymphadenopathy.6.Left upper lobe opacity better characterized on concurrent CT chest.