Hello! Thank you for your question on HCM! Regarding your concern I would say that it is a past lesion to the brain. It is not very specific for only one disorder. Have you suffered from headache like migraine. It can be caused by low blood perfusion to the brain in that region. Do you suffer from high blood pressure or heart disease? Have you ever had problems like tingling sensation,numbness or weakness in your right limbs? A demyelinating disease like multiple sclerosis can cause similar lesions in MRI. The MRI images should be confronted with your symptoms to find out the nature of this lesion. Further examination of the heart, blood analysis, cervical vessel ultrasound are needed to establish the cause. Hope to have been helpful! Best wishes Dr Abaz