New onset seizure. The ventricles and sulci are mildly prominent consistent with mild global parenchymal volume loss. The basal cisterns remain patent. There is no midline shift or mass effect. There is no evidence of restricted diffusion to suggest ischemic infarction. There is an area of FLAIR hyperintensity involving the right lateral temporal lobe predominantly involving the subcortical white matter of the right inferior temporal gyrus and to a lesser degree the right middle temporal gyrus. There is associated mild gyral expansion in this region. There is associated patchy enhancement as well as minimal associated susceptibility artifact suggesting possible blood products (although assessment for hemorrhage is limited). The brain parenchymal signal is otherwise within normal limits. There is no significant leptomeningeal enhancement or evidence of abscess. The major dural sinus venous sinus system appears grossly patent. No extra-axial fluid collection is identified. Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. There is swelling involving the right frontal scalp consistent with recent trauma. The skull and paranasal sinuses appear grossly unremarkable.
1.Edema and enhancement involving the lateral aspect of the right temporal lobe which may be related to infection/encephalitis. Posttraumatic contusion seems less likely given presence of minimal if any blood products as well as degree of enhancement), Neoplasm is not excluded. Venous infarct seems much less likely. Lumbar puncture can be considered if infection is clinically suspected.2.Mild global parenchymal volume loss, prominent for age.3.Right frontal scalp swelling consistent with recent trauma.