Diagnosis: Unspecified epilepsy without mention of intractable epilepsyClinical question: h/o epilepsy s/p hippocampal laser ablation The patient is status post bilateral parietal bone and right temporal bone burr hole placement. There are T2 and FLAIR hyperintense tracts extending from the burr holes into the brain parenchyma.There is redemonstration of abutting irregularly shaped ring-enhancing lesions located in the right hippocampal head together measuring 15 x 20 cm in axial dimensions. This was also present on prior exam from 6/2/2015. On T1-weighted imaging and is bright and intermediate signal. On T2-weighted imaging it is predominantly low signal. On FLAIR MRI imaging it is low signal centrally and high signal peripherally. There is no evidence for diffusion restriction associated with it.The CSF spaces are appropriate for the patient's stated age with no midline shift. Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.There is a ring-enhancing lesion present in the right hippocampus. Most likely this is related to blood products at the prior treatment site. Please correlate with surgical findings.