Aphasia [R47.01], Reason for Study: ^Reason: eval for pathology, s/p crani for R MCA and L ICA aneurysms. History: aphasia Due to metallic artifact, precise evaluation with diffusion-weighted imaging and gradient-echo imaging are limited.However, there is no evidence of acute ischemic lesion on the scan.There are localized and somewhat gyral pattern FLAIR/T2 high signal intensity lesions at the left anterior temporal lobe surface area (series 6, image 12,13,14). There are also associated FLAIR/T2 high signal intensity lesions at the left anterior and mesial temporal area. This lesion is likely to be intra axial and indicate possible hemorrhagic lesions as well as associated parenchymal edema likely related to prior operation.There is also extra dural fluid collection extending from the left frontal lobe 2 to temporal lobe and the maximum diameter was measured about 11 mm on axial T2 images with subtle effacement of underlying brain parenchyme. The maximum diameter measured on prior CT scan was about 10.1 mm, thus, considering different imaging modality, there is no significant interval change of extradural fluid collections.There is also scalp fluid collections with air signal intensities which are related to prior operation, unchanged since prior scan.Minimal (about 1-2mm) midline shift toward right side is again seen but unchanged since prior scan.The ventricles, sulci and cisterns are symmetric.There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, or restricted diffusion/acute ischemia. The cranial-cervical junction are normal. The paranasal sinuses and mastoid air cells are clear.
1. Left temporal lobe likely hemorrhagic lesion and edematous lesions, likely represent prior surgery related lesions as described above (series 6, image 12,13,14).2. No evidence of acute ischemic lesion.3. Unchanged extra dural fluid and air collections since prior scan with subtle effacement of underlying brain parenchyme since prior scan.4. Unchanged subgaleal fluid and air collection since prior CT scan.