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Click 35 year old female with a history of pontine cavernous malformation, now with headaches and 6th nerve palsy. CT topograms.

Click 35 year old female with a history of pontine cavernous malformation, now with headaches and 6th nerve palsy. Unenhanced axial CT (GE Lightspeed Pro16, 140 mA, 142 kV, 5mm slice thickness) showing a focal hyperdensity in the left pons with mass effect on the 4th ventricle compatible with acute hemorrhage.

Click 35 year old female with a history of pontine cavernous malformation, now with headaches and 6th nerve palsy. MR localizers.

Click 35 year old female with a history of pontine cavernous malformation, now with headaches and 6th nerve palsy. MR images obtained on GE Excite 1.5T magnet. Axial noncontrast T1 (Spin Echo, TR 650, TE 13, NEX 1, flip angle 90) show focal hemorrhage into the left posterior pons. Blood products of varying ages are demonstrated by bight signal on T1 and T2 corresponding to subacute blood with foci of T1 and T2 low signal representing more acute hemorrhage.

Click 35 year old female with a history of pontine cavernous malformation, now with headaches and 6th nerve palsy. MR images from GE Excite 1.5T magnet. Saggital noncontrast T1 images(Spin Echo, TR 483, TE 13, NEX 1, flip angle 90, slice thickness 5mm) show focal hemorrhage into the left posterior pons. Blood products of varying ages are demonstrated by bight signal on T1 and T2 corresponding to subacute blood with foci of T1 and T2 low signal representing more acute hemorrhage.

Click 35 year old female with a history of pontine cavernous malformation, now with headaches and 6th nerve palsy. MR images from GE Excite 1.5T magnet. T2 fast spin echo sequence (TR 3500, TE 129, NEX 1, Flip angle 90, echo train length 28) show focal hemorrhage into the left posterior pons. Blood products of varying ages are demonstrated by bight signal on T1 and T2 corresponding to subacute blood with foci of T1 and T2 low signal representing more acute hemorrhage.

Click 35 year old female with a history of pontine cavernous malformation, now with headaches and 6th nerve palsy. MR localizers.

Click 35 year old female now status post resection of her pontine cavernous malformation with MR (Siemens Symphony 1.5T) obtained 7 months post-operatively. Axial spin echo T1 noncontrast images (TR 389, TE 8, NEX 1, Flip angle 90) show hypertrophy of the inferior olive.

Click 35 year old female now status post resection of her pontine cavernous malformation with MR (Siemens Symphony 1.5T) obtained 7 months post-operatively. (A) Axial T2 fast spin echo (TR 4340, TE 91, NEX 1, Flip angle 150, Echo train length 13, slice thickness 5mm) at the level of the middle cerebellar peduncle shows chronic blood products and gliosis at the site of the resected cavernous malformation. More inferiorly at the level of the internal auditory canals there is signal hyperintensity of the left inferior olive.

Click 35 year old female now status post resection of pontine cavernous malformation with MR (Siemens Symphony 1.5T) obtained 7 months post-operatively. Axial FLAIR image (TR 7500, TE 93, IT 2500, NEX 1, Flip angle 150, Echo train length 15) best demonstrates the T2 signal changes and marked signal hyperintensity of the left inferior olivary nucleus.