NM_006218.4:c.1911+19G>T is absent from all population databases including gnomAD v2.1, v4.1, and gnomAD-Canada, meeting PM2 at Supporting strength under the Brain Malformations VCEP v1.1.¹ No affected individuals have been reported with this variant; it is absent from ClinVar, COSMIC, and the literature, yielding zero points for PS4 under Table 2A.² PVS1, PP3, and BP1 are not applicable under the Brain Malformations VCEP because the PIK3CA disease mechanism for cerebral malformations is gain-of-function.³ The variant is intronic (c.1911+19) and does not alter an amino acid residue; splice prediction by SpliceAI shows no significant impact (max delta score = 0.01). PS1, PM1, PM5, and PP2 are not applicable because they require amino acid-level changes.⁴ BP4 and BP7 could not be fully assessed — BP4 requires two of three splicing tools (only SpliceAI available; missing varSEAK and MaxEntScan) and BP7 requires a PhyloP conservation score (unavailable).⁵ Applying the Brain Malformations VCEP Tavtigian point framework: only PM2_Supporting (+1 point) is met. Total score of +1 falls in the VUS range (0-5 points).⁶