Left facial and neck shooting pain, dizziness, evaluate for progression of known glomus tumor in left upper carotid sheath and jugular fossa. MRI Brain and Neck: There are post-surgical changes of a partial left mastoidectomy with fluid signal in the residual air cells. There is redemonstration of mildly T2 hyperintense mass with flow voids and metal clips in the left jugular foramen with infiltration into the left middle ear cavity. Overall, the tumor measures up to approximately 22 mm. There is no evidence of intracranial hemorrhage or acute infarct. There are scattered areas of periventricular and subcortical white matter hyperintensity, suggestive of chronic small vessel ischemic disease. The brain parenchyma and pituitary gland otherwise appear unremarkable. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. There are bilateral lens implants. There is scattered mild paranasal sinus mucosal thickening. There appears to be a subcentimeter Thornwaldt cyst.MRA Brain and Neck: The exam is mildly motion degraded. There is no evidence of cerebral aneurysm or flow-limiting stenosis, occlusive thrombus, or dissection in the head and neck arteries.
1. Post-surgical changes related to partial left mastoidectomy with evidence of a residual jugulotympanicum paraganglioma measuring up to approximately 22 mm. Fluid in the remaining left mastoid air cells may represent acute mastoiditis.2. No evidence of aneurysm, flow-limiting stenosis, occlusive thrombus, or dissection in the head and neck arteries.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.