Young man with encephalopathy and hallucinations and history of seizures and history of brain abscess a long time ago. There is extensive encephalomalacia in the right anterior frontal lobe with marked ex vacuo dilatation of the right lateral ventricle and there is a small area of encephalomalacia in the right basal ganglia. There is also a 10 mm diameter area of cystic encephalomalacia in the left parietal lobe, which may communicate with the left lateral ventricle and is surrounded by mild T2 hyperintensity. There is no abnormal intracranial enhancement. There is diffuse cerebellar volume loss. The hippocampi are unremarkable. There is no significant midline shift or herniation. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The major cerebral flow voids are intact. There appear to be postoperative findings in the right frontal bone. There is otherwise diffuse thickening of the calvarium. The orbits are grossly unremarkable.
1. Apparent remote postoperative findings in the right frontal region with extensive encephalomalacia in the right anterior frontal lobe with marked ex vacuo dilatation of the right lateral ventricle and a small chronic lacunar infarct in the right basal ganglia. 2. Probable porencephalic cyst measuring 10 mm in diameter in the left parietal lobe.3. Diffuse cerebellar volume loss and diffuse thickening of the calvarium are likely related to chronic seizure therapy.