Clinical question: History epilepsy and drop attacks. Signs and symptoms: Preoperative planning for laser ablation callosotomy. Pre-and post-enhanced fusion brain MRI:Similar to prior exam there is generalized prominence of cortical sulci and cerebellar -- vermian folia for stated age of 29 and consistent with underlying parenchymal volume loss. Large focus of encephalomalacia in the right anterior temporal and with evidence of a right temporal craniotomy is noted. Smaller focus of primary cortical encephalomalacia in the left anterior temporal lobe under a left temporal craniotomy is also noted. There is no detectable abnormal enhancement the brain parenchyma or the pia- meninges. Examination is performed as surgical planning study and is not a true and complete diagnostic exam.
1.Large right anterior temporal and a smaller left anterior temporal foci of encephalomalacia and evidence of prior craniatomy.2.Generalized prominence of the cortical sulci and cerebellar -- vermian folia consistent with underlying parenchymal volume loss.3.No detectable abnormal enhancement.