75 year-old female with abnormal spells daily, abnormal EEG consistent with seizures, evaluate temporal lobes versus atrophy. There is no evidence of intracranial hemorrhage, mass, or acute infarct. Ventricular sizes and sulci are within acceptable limits for a patient of age 75 years. There are mild scattered foci of high T2 signal within periventricular and subcortical white matter, consistent with sequela of chronic small vessel ischemic disease, unchanged in extent. The ventricles and basal cisterns are normal in size and configuration. The skull and extracranial soft tissues are unremarkable. There are no abnormal enhancing foci.Dedicated coronal FLAIR imaging demonstrates a suggestion of increased T2 hyperintensity within bilateral hippocampi, however internal hippocampal architecture is preserved and hippocampal size is within normal limits. There is no preferential mesial temporal lobe atrophy.
1.Stable chronic small vessel ischemic disease.2.Dedicated coronal FLAIR imaging demonstrates a suggestion of increased T2 hyperintensity within bilateral hippocampi, however internal hippocampal architecture is preserved and hippocampal size is within normal limits. Given this nonspecific appearance, it is of uncertain clinical significance.