Encephalitis and encephalomyelitis, unspecified [G04.90] / Epilepsy, unspecified, not intractable, without status epilepticus [G40.909], Reason for Study: ^Reason: Follow up scan re evaluated anterior temporal lobe lesion History: Seizure disorder There is no acute hemorrhagic lesion.There is no abnormal enhancement.There is focal DWI high signal intensity on the right basal ganglia (series 601, image 242) which shows suspicious diffuse restriction on ADC map but clearly showing T1/FLAIR high signal intensity. Thus, this lesion is likely represent T2 shine through instead of acute ischemic lesion.Previously demonstrated subtle increased FLAIR/T2 signal intensity on bilateral mesial temporal lobe appear to be stable, unchanged since prior scan. Left posterior inferior thalamic tissue defect indicating chronic stroke. Non specific patchy multifocal somewhat confluent bilateral periventricular white matter and centrum semiovale, unchanged since prior scan.The ventricles, sulci and cisterns are symmetric and unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia, or abnormal contrast enhancement. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.
1. No acute ischemic or hemorrhagic lesion.2. No abnormal enhancement.3. Unchanged subtle increase of bilateral mesial temporal lobe on FLAIR/T2 images.4. Interval development of focal T2/FLAIR high signal intensity lesion on the right basal ganglia. This is non specific but differential diagnosis includes chronic ischemic lesion or small vessel disease.