56 years, Male, right temporal lobe epilepsy. Surgical candidate. There is T2/FLAIR hyperintensity involving the bilateral hippocampi, right greater than left. Right hippocampal volume is grossly preserved with the left hippocampus slightly smaller than the right.Remainder of the brain parenchyma demonstrates scattered foci of T2/FLAIR hyperintensity in the bilateral periventricular and subcortical white matter which are nonspecific but compatible with mild chronic small vessel ischemic changes. There is mild supra and infratentorial parenchymal volume loss. No evidence of infarct or hemorrhage. No intracranial mass or mass effect. No hydrocephalus. No extra-axial collections. Calvarium and extracranial soft tissues are grossly unremarkable.
The right hippocampus is slightly larger than the left and demonstrates asymmetric high T2/FLAIR hyperintensity compared to the left. These findings may be a postictal in etiology. 