 The examination is slightly limited by motion artifact. There is pronounced volume loss involving the temporal lobe, including the hippocampus, where there appears to be mild T2 hyperintensity. There is a background of diffuse cerebral volume loss as well. There is no midline shift or mass effect. There is no abnormal intracranial enhancement. There is no diffusion abnormality. Normal flow-voids are demonstrated in the major intracranial vascular structures. There is a 10 mm periapical cyst involving tooth number 9. There is minimal paranasal sinus mucosal thickening.
The pronounced atrophy of the right temporal lobe appears grossly similar to prior examination and may represent the sequela of a prior encephalitis.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.