Hypothalamic hamartoma and gelastic seizures; planning for laser ablation. There has been continued evolution of the signal characteristics of the laser ablation zone within the exophytic hypothalamic hamartoma, which has again decreased slightly in size. There is concentric enhancement at the ablation site in the left lateral aspect of the lesion. The optic apparatus demonstrates normal signal characteristics. There is a non-enhancing T2 hyperintense focus in the region of the right anterior frontal lobe subcortical white matter that measures up to 12 mm, which has gradually increased in size. There is no evidence of acute cerebral infarction or hemorrhage. The ventricles are unchanged in size. There are findings related to prior frontal craniotomy and transcallosal surgery. There are small retained secretions within the left sphenoid and ethmoid sinuses. There is a small amount of persistent high T2 signal within the right mastoid tip air cells.
1. Expected evolution of findings related to MRI guided laser ablation of a hypothalamic hamartoma, which has decreased slightly in size. 2. A nonspecific lesion in the region of the right frontal lobe that measures up to 12 mm has gradually increased in size. This may represent a hamartoma of low-grade neoplasm.