57-year-old female with generalized and partial seizures. This examination is degraded by motion. No restricted diffusion to suggest acute ischemia. No acute intracranial hemorrhage. No intracranial mass or mass-effect. The ventricles are within normal limits in size and configuration. The right hippocampus has slightly increased T2/FLAIR signal in comparison to the left and is also slightly smaller than left hippocampus. There is no evidence of cortical dysplasia or gray matter heterotopia. Multiple foci of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter, which are nonspecific. Encephalomalacia is again seen in the right posterior cerebellar hemisphere. A small area of susceptibility artifact is located in this region is redemonstrated, compatible with chronic blood products. A right lateral occipital craniotomy defect is again noted. Major flow-voids are preserved. Sella and orbits are grossly within normal limits. Scattered mild mucosal thickening is noted in the paranasal sinuses. Mastoid cells are clear.
Motion degraded examination, which may obscure detection of subtle seizure foci.1. Asymmetric smaller and T2/FLAIR hyperintensity of the right hippocampus may represent mesial temporal sclerosis. No intracranial mass, evidence of cortical dysplasia or gray matter heterotopia.2. Nonspecific signal change in the supratentorial white matter may be related to prior ischemia, inflammation, or less likely demyelinating disease. Unchanged since 6/24/2015.3. Evidence of remote trauma with right inferior cerebellar encephalomalacia with overlying craniotomy, unchanged.