Neuro_MR_Brain: 49 M, right anterior temporal hemorrhage.

MRI BRAIN WITH AND WITHOUT CONTRAST:

 

CLINICAL HISTORY: 47-year-old male with loss of consciousness while driving a few weeks ago, with subsequent seizure episodes, and prior MRI imaging demonstrating a right anterior temporal lobe lesion, with no evidence of aneurysm on outside cerebral angiography.

 

FINDINGS: The study is degraded by patient motion.

 

Parenchyma: Right anterior temporal lobe lesion demonstrating heterogeneous T1 signal intensity and blooming on GRE, compatible with blood products. The lesion is closely associated with the distal right M1 and proximal right M2 branches, without definite communication. There are well defined borders suggestive of vascular etiology. Lesion is increased in size from prior, now measuring 3.4 x 3.1 cm, previously 2.8 x 2.2 cm. There has been a mild interval increase in adjacent vasogenic edema and local mass effect, with mild interval increase in effacement of the right lateral ventricle, minimal right uncal herniation. 

 

Ventricles and extra-axial spaces: Appropriate for age.

 

Orbits: Normal.

 

Visualized paranasal sinuses: Clear.

 

Mastoid air cells: Clear.

 

Bones: Normal.

 

Additional comment: None.

 

IMPRESSION:

 

1. Increased size of right anterior temporal lobe lesion with mildly increased surrounding edema and local mass effect. Though no definite connection to vasculature is seen, findings remain concerning for aneurysm given appearance and interval increase in size. Additional considerations include cavernous malformation, and neoplasm such as hemorrhagic metastasis.