61 years, Female, obsessive-compulsive disorder. Examination for intraoperative guidance. There are postoperative changes of bilateral frontal lead placement for laser ablation, with the fiber tips at the level of the anterior limbs of the internal capsule bilaterally. Prior sites of ablation are noted with intrinsic T1 hyperintensity involving the white matter adjacent to the frontal horns. There is enhancement at the levels of the anterior limbs of the internal capsule as well as slightly more cranially compatible with sites of ablation. Corresponding areas of restricted diffusion are also noted. Expected postsurgical changes also include small amount of pneumocephalus. No large intracranial hemorrhage or significant mass effect is appreciated. No hydrocephalus.
Expected postsurgical changes of repeat bilateral laser ablation of the anterior limbs of the internal capsules with areas of enhancement and restricted diffusion.