Evaluate for possible recurrence of cavernous malformation: Breakthrough seizures, punctate hyperdense lesion in mesial right temporal lobe on CT. There are postoperative findings in the medial right temporal lobe with areas high T2 signal and volume loss. There is also a small amount of susceptibility effect in the right hippocampus. There is no evidence of acute intracranial hemorrhage or acute infarct. There is no abnormal intracranial enhancement. The ventricles are uncahnged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits are grossly unremarkable. There is scattered mild paranasal sinus mucosal thickening. There is a subcentimeter midline nasopharyngeal cyst.
Postoperative findings in the medial right temporal lobe with areas of encephalomalacia and perhaps gliosis, as well as a small amount of chronic blood products versus a small amount of residual component of a cavernous malformation in the right hippocampus.