Evaluate temporal lobe abscess: headaches, recurrent mastoiditis. History of mastoiditis status post tympanomastoidectomy and craniotomy with post-auricular incision with draining fistula tract. There are postoperative findings related to right tympanomastoidectomy and temporal craniotomy with diffuse enhancement of the overlying subcutaneous tissues and in the bone marrow surrounding the mastoid bowl, as well as high T2 signal in the mastoid bowl and few remaining right mastoid air cells. There is a peripherally enhancing lesion with diffuse T1 and T2 hypointensity and susceptibility effect, which corresponds to previously demonstrated calcifications, in the right inferior temporal lobe overlying the tegmen mastoideum that measures 12 mm in diameter with extensive surrounding edema. There is no evidence of acute intracranial hemorrhage or acute infarct. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact, including the right sigmoid and internal jugular veins. The orbits are grossly unremarkable.
Postoperative findings in the right temporal region with a lesion in the right inferior temporal lobe that is compatible with a residual abscess, perhaps with granuloma formation, as well as suggestion of osteomyelitis and mastoiditis in the region of the right mastoidectomy cavity along with overlying cellulitis and/or treatment effects.