Clinical question: History of epilepsy, planning for laser fiber placement. Signs and symptoms: As above. Pre-and post-enhanced fusion brain MRI:There is no detectable acute or new finding since prior MRI exam from 2 -- 17 -- 15.Subtle enlargement of the tip of the right temporal horn of lateral ventricle and its adjacent sulci remains identical to prior exam.There are tracks of deep electrodes extending from the medial aspect of right hippocampus directly laterally and exiting the calvarium as are the directly posterior to the exiting calvarium in the right posterior temporal -- occipital junction. Focus of T2 hyperintensity in the right anterior temporal tip with resultant sulcal effacement of adjacent cortical sulci is new since prior exam and likely representing posttreatment change. Note should be made that this exam is a limited surgical -- treatment planning the study and not a diagnostic test. Cavum septum pellucidum and normal-size ventricular system without deviation of midline as was noted on prior studies.There is expected subtle dural thickening and enhancement at the surgical site in the right anterior temporal region and unremarkable post-enhanced images otherwise.
1.Focus of T2 hyperintensity in the right anterior temporal lobe laterally is a new finding since prior exam and could represent post treatment course surgical change.2.Tracks of electrodes traversing the right anterior temporal lobe directly laterally as well as posteriorly as detailed.