Clinical question: History of vascular malformation of the left frontal lobe, follow-up. Signs and symptoms: Mild headache. Nonenhanced brain MRI: No diffusion weighted abnormalities.Susceptibility MRI images demonstrate a small curvilinear focus of susceptibility in the left superior frontal gyrus measuring approximately at 9 x 5-mm in transaxial dimensions. This finding is not identified on any of the other MRI sequences and there is no associated flair/T2 signal abnormality of the surrounding parenchymal. There are no prior exams for comparison. This finding could represent a focus of chronic hemorrhage. Although not typical in signal pattern possibility of a vascular malformation such as a cavernoma should also be considered.The anatomical morphology as well as the cecum intensity of brain parenchyma otherwise remains within normal for patient's stated age of 47. Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and brain myelination.There is normal visualization of signal void of major intracranial arterial branches.The signal intensity of intracranial venous sinuses is again normal.Images through the orbits are unremarkable. All paranasal sinuses and bilateral mastoid air cells demonstrate normal pneumatization signal pattern with the exception of small focus of mucosal thickening in the inferior right maxillary sinus.
1.No acute intracranial process.2.Susceptibility signal change measuring 9 x 5-mm visible only on susceptibility MR sequence and without associated flair/T2 signal abnormality. Finding could represent a focus of chronic blood products and although not entirely typical possibility of a cavernous malformation cannot be entirely excluded.3.Unremarkable pre-and post enhanced brain MRI otherwise.