Evaluation of mass in R parietal lobe found on CT scan of OSH. Seizures, altered mental status. There is an ill-defined infiltrative T2 hyperintense lesion in the inferior right temporal lobe predominantly involving the white matter. However, there are scattered foci of signal abnormality also involving the cortex extending into the insula and to the parieto-temporal junction. A T2 hyperintense lesion is present in the posterior medial right thalamus. The right amygdala and hippocampus appears thickened and mildly T2 hyperintense. There is no obvious postcontrast solid nodular enhancement. However, there is substantial sulcal enhancement both in the vicinity of the mass and rather diffusely in the right cerebral hemisphere. At least some of this enhancement appears to be related to increased vascularity however leptomeningeal enhancement is not entirely excluded. There is effacement of the temporal horn of the right lateral ventricle, otherwise the ventricles appear nondistended. No definite acute intracranial hemorrhage is identified. There is no midline shift.
There is an ill-defined T2 hyperintense process involving the right temporal lobe, insula, parieto-temporal cortex, posterior right thalamus,and questionably the medial temporal structures. Although there is no definite solid nodular enhancement, there is significant sulcal enhancement some of which is at least in part related to increased vascularity in the region. Although the differential considerations are broad and include neoplastic as well as nonneoplastic etiologies, the possibility of a malignancy, including higher grade primary brain tumors, would need to be considered.