Epilepsy, surveillance. Again seen are postsurgical changes related to right amygdo-hippocampal laser ablations. There is continued evolution of laser ablation affects involving the right hippocampus and posterior amygdala with increase in encephalomalacia. Previously seen nodular enhancement in this region has decreased, also consistent with evolution.Evidence of prior burr holes as well as focus of encephalomalacia in the right frontal lobe along a prior surgical tract is again seen. Foci of chronic hemorrhage are also evident along the surgical tracts including in the right medial temporal lobe.There is no evidence of acute infarct, new hemorrhage, intracranial mass, or mass effect. No midline shift or herniation. Ventricles are normal in size. Major flow-voids are preserved.
Continued evolution of the laser ablation effects involving the right hippocampus and posterior amygdala with mild increase in encephalomalacia and decrease in enhancement at the ablation site. 