Male, 22 years old, with seizures, concern for HSV encephalitis. No definite restricted diffusion is seen. A few scattered small foci of FLAIR hyperintensity and questionable DWI hyperintensity within the sulci, including one within the posterior right sylvian fissure, are nonspecific and could potentially be artifactual. Two or three additional punctate foci of parenchymal FLAIR hyperintensity are nonspecific as well.No evidence of edema or mass effect is seen. No pathologic parenchymal or extra-axial enhancement is observed. No intracranial hemorrhage or any abnormal extra-axial fluid collections are seen. Ventricular size and morphology are within normal limits. The mesial temporal lobes are normally formed, symmetric and free of focal signal abnormality.
No definite findings are seen to account for the patient's symptoms. A few foci of hyperintense signal involving scattered cerebral sulci are nonspecific and could potentially be artifactual. While a subtle infectious process cannot be entirely excluded, no findings characteristic of an HSV encephalitis are seen on this exam.