Reason: h/o epilepsy s/p laser ablation History: surveillance The CSF spaces are appropriate for the patient's stated age with no midline shift. There is redemonstration of a abnormal signal in the left hippocampus (including had and tail) on flair and T2 weighted images which extends towards the left amygdala. There is no associated contrast enhancement. Compared to prior exams the signal in the left hippocampus is more heterogeneous. There is new T2 and flair signal hyperintensity in the adjacent left parahippocampal gyrus was not present on the exams from a year ago which displays a small amount of contrast enhancement. There is a small susceptibility effect present at the left hippocampus which was not present on prior exams. There is a associated mild enlargement of the temporal horn of the left lateral ventricle indicating adjacent volume loss due to ex vacuo effect.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus. Incidental note is made of a developmental venous anomaly in the left cerebellar hemisphere.The visualized portions of the paranasal sinuses demonstrate mucosal thickening in the right maxillary sinus. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.Findings compatible with post treatment change involving the left hippocampus and now left parahippocampal gyrus.