Reason: rule out structural lesions History: seizures. The ventricles and sulci are within normal limits. The basal cisterns remain patent. There is no midline shift or mass effect. A fusiform shaped area of increased T2 signal, increased FLAIR signal, and decreased T1 signal along the left external capsule is favored to reflect an atypical prominent perivascular space. There are a a few additional punctate foci of increased T2/FLAIR signal scattered through the subcortical white matter which are nonspecific. Brain parenchymal signal is otherwise within normal limits. Thin sections through the temporal lobes demonstrate mild asymmetric prominence of the temporal horn of the left lateral ventricle without associated hippocampal signal abnormality. There is no diffusion abnormality. No extra-axial fluid collection is identified. Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. The orbits, skull, and scalp soft tissues are grossly unremarkable. There is minimal patchy opacification within the paranasal sinuses.
1.A few punctate foci of increased T2/FLAIR signal within the subcortical white matter are seen which are nonspecific but atypical for age. Differential considerations include gliosis, demyelination, sequelae of prior inflammation, or vascular/ischemic etiologies. 2.Questionable asymmetric hippocampal structures with the left smaller than the right without associated signal abnormality and of uncertain clinical significance.