Received Jan 26, 2026
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| COVID19 | COVID19 (COVID19 (PFIZER-BIONTECH)) | PFIZER\BIONTECH | 1 | EN6199 | SYR / UN |
| COVID19 | COVID19 (COVID19 (PFIZER-BIONTECH)) | PFIZER\BIONTECH | 2 | ER8239 | SYR / UN |
The patient developed a cavernoma that ruptured and caused permanent hearing loss in his left ear.
10/20/2023: EKG - Sinus Rythm CT Head W/O Contrast - No acute intracrannial process is identified CT Angiogram Head Stroke - No evidence of significant intracranial carotid artery or vertebral basilar disease + No evidence of significant stenosis of the extracranial carotid or vertebral arteries CT Angiogram Neck Stroke - No evidence of significant intracranial carotid artery or vertebral basilar disease + No evidence of significant stenosis of the extracranial carotid or vertebral arteries XR Chest - No significant acute radiographic abnormalities of the chest 10/31/2023: MRI Brain W/O Contrast - 5.7 x 5.1 mm well-circumscribed lesion involving the origin of left CN VII/VIII complex at left cerebellopontine angle cistern with associated restricted diffusion. Adjacent patchy T2/FLAIR signal abnormality involving the left inferolateral pons at the origin of left CN VII/VIII complex also noted. No convincing evidence of underlying enhancement; can be obscured by intrinsic T1 hyperintense signal of the abnormality at this time. Differential considerations include sequelae of small acute/subacute ischemia involving left inferolateral pons with adjacent left CN VII/VIII complex hemorrhagic neuritis. Other differential is small hemorrhagic left vestibular schwannoma with adjacent reactive signal changes involving left inferolateral pons at the origin of nerve complex. Short-term follow-up with MRI IAC study recommended in 3 months. CT temporal bone study is available to appropriately assess the bony labyrinth of the inner ear and other pertinent osseous structures of the temporal bone. No other abnormal intracranial enhancing mass/lesion. 3. Small left mastoid effusion around the cochlear apparatus. A Orange alert message has been sent via the PowerConnect Actionable Findings system on 11/3/2023 11:03 AM MRI IACS W & W/O Contrast - 5.7 x 5.1 mm well-circumscribed lesion involving the origin of left CN VII/VIII complex at left cerebellopontine angle cistern with associated restricted diffusion. Adjacent patchy T2/FLAIR signal abnormality involving the left inferolateral pons at the origin of left CN VII/VIII complex also noted. No convincing evidence of underlying enhancement; can be obscured by intrinsic T1 hyperintense signal of the abnormality at this time. Differential considerations include sequelae of small acute/subacute ischemia involving left inferolateral pons with adjacent left CN VII/VIII complex hemorrhagic neuritis. Other differential is small hemorrhagic left vestibular schwannoma with adjacent reactive signal changes involving left inferolateral pons at the origin of nerve complex. Short-term follow-up with MRI IAC study recommended in 3 months. CT temporal bone study is available to appropriately assess the bony labyrinth of the inner ear and other pertinent osseous structures of the temporal bone. No other abnormal intracranial enhancing mass/lesion. Small left mastoid effusion around the cochlear apparatus. A Orange alert message has been sent via the PowerConnect Actionable Findings system on 11/3/2023 11:03 AM 11/16/2023: MRI Interpretation of Outside Films Neuro - Interpretation of outside facility MRI brain internal auditory canal/posterior fossa performed on October 31, 2023 submitted for review on November 16, 2023 1. Intrinsically T1 hyperintense lesion with restricted diffusion and hemosiderin staining at the left cerebellopontine. No definite associated enhancement. Adjacent edema within the left inferolateral pons/middle cerebellar peduncle. Differential considerations include cavernoma with associated hemorrhage and reactive edema versus hemorrhagic infarct versus less likely a neoplastic process such as a hemorrhagic nerve sheath tumor or metastases (e.g. melanoma). Recommend short interval follow up to evaluate for evolution. 2. Incidentally noted proximal basilar artery fenestration. RECOMMENDATION Short interval follow MRI 12/12/2023: MRI Brain W & W/O Contrast - Interval resolution of the previously noted T1 shortening in the left cerebellopontine angle adjacent to the left vestibulocochlear nerve complex. A small focus of encephalomalacia is also noted in the left brachium pontis as detailed above. These findings are indicative of a resolving, small hemorrhage. A possible small cavernous malformation at this location is possible. 12/13/2023: Comprehensive Hearing Test 6/4/2024: MRI Brain W & W/O Contrast - Decreased size of the hemorrhagic lesion in the left cerebellopontine angle adjacent to the left vestibulocochlear nerve complex , possibly a small cavernoma with evolving hemorrhagic changes. Unchanged minimal encephalomalacia in the left brachium pontis and resolved associated vasogenic edema. 12/5/2024: MRI Brain W & W/O Contrast - Significant interval improvement in the area of hemorrhage at the insertion of the 7th and 8th cranial nerves. Hemorrhage near completely cleared with only minimal residual hemosiderin. No mass or edema seen. Ideology is indeterminate. This may represent hemorrhage in the nerve. A small schwannoma is not excluded though felt less likely as there is no abnormal enhancement in this area on the current exam. Residual from infectious or inflammatory process would be a potential etiology. Again there does appear to be significant improvement in the interval. Aneurysm is felt unlikely as the blood products have diminished and there is no flow enhancement in this area on the current study postcontrast. The remainder of the exam is unremarkable.