 There are recent post ablation changes in the brain including mild pneumocephalus. There are faint intrinsic T1 hyperintense blood products with no definite superimposed enhancement in the rostral, genu, and body of the right corpus callosum at the known laser ablation sites, with surrounding rim of FLAIR hyperintensity and diffusion restriction likely relating to expected post procedural ischemic changes. There is a new linear FLAIR hyperintense tract in the right frontal lobe representing laser electrode tract, as well as linear susceptibility along the right temporal and occipital lobes consistent with laser fiber tract. There is mild mass effect on the right lateral ventricle without significant midline shift. There is trace extra-axial FLAIR hyperintensity along the parietal occipital lobes bilaterally, likely representing postoperative blood products. There may be minimal subarachnoid blood products right parietal convexityThere are remote postsurgical changes from right frontoparietal craniotomy for right anterior temporal lobe resection with resulting encephalomalacia. There are also remote postsurgical changes related to left frontoparietal craniotomy with smaller left anterior temporal lobe encephalomalacia. There is diffuse thin linear dural enhancement which is likely postsurgical. There is no acute infarct or suspicious intracranial enhancement otherwise. Prominence of the pineal gland with focal FLAIR hyperintensity is again seen, likely relating to intrinsic cysts.
1. Expected post laser ablation changes within the right corpus callosum and elsewhere within the brain as detailed above with no evidence of significant hemorrhage or large infarct. Mild localized mass effect on the right frontal horn.2. Changes from remote craniotomies with right much greater than left temporal lobe encephalomalacia.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.