The region of susceptibility artifact involving the left temporal lobe is smaller and consistent with the known focus of previous intraparenchymal haemorrhage. There is much reduced surrounding T2/FLAIR hyperintensity in keeping with near resolved surrounding oedema. Within this region, there is no vascular nidus or serpiginous flow voids to suggest an underlying vascular malformation. No prominent or enlarged arteries are identified within the region. The dedicated MRA of the region is unremarkable demonstrating no aneurysm, stenosis or vascular malformation.
Incidentally however, at the medial aspect of the right precentral gyrus (parasagittal location) there is 6 mm vascular nidus of cortical / pial vessels. No definite large draining vein is identified on the preceding MR venogram study nor adjacent thrombosed vein. There is no evidence of gliosis or haemorrhage within this region.
The left midbrain ( left superior colliculus ) focus of high T2 signal is unchanged and consistent with previous haemorrhage. No other regions of signal abnormality is identified. No acute haemorrhage or extra-axial collection.
Conclusion:
There is near complete collapse of the haemorrhagic cavity in the left temporal lobe. No underlying vascular malformation or underlying mass lesion is identified within the left temporal lobe. There is also an incidental 6 mm presumed pial arteriovenous malformation involving the medial aspect of the right precentral gyrus.