Seizures, question meningioma There is an extra-axial homogeneously enhancing mass along the left anterior temporal convexity measuring approximately 33 x 43 x 36 mm in the AP, transverse, and craniocaudal dimensions. Small associated dural tail best appreciated on the sagittal images. There is small amount of susceptibility effect centrally which may be related to mineralization. There is associated mass-effect on the anterior aspect of the left superior and middle temporal gyri as well as the left frontal operculum. No significant associated parenchymal edema. No restricted diffusion to suggest acute ischemia. No intracranial hemorrhage. No other intracranial mass. No midline shift or downward herniation. The ventricles are within normal limits in size and configuration. Several foci of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter as well as in the pons, which are nonspecific, but most compatible with chronic small vessel ischemic changes. Brain parenchyma is otherwise unremarkable for age. Major flow-voids are preserved with the left middle cerebral artery slightly posteriorly displaced from the mass effect.There is a cystic, tubular lesion involving the left inferior aspect of the parotid gland which is incompletely imaged. There appears to be branching associated. There T2 hyperintensity without central enhancement. Lesion measures approximately 1 cm in width and extends at least 3.5 cm in length.Partially empty sella. Paranasal sinuses and mastoid cells are clear. Bone marrow signal and extracranial soft tissues are within normal limits.
1. 33 x 43 x 36 mm extra-axial enhancing mass along the left anterior inferior frontotemporal convexity most likely represents a meningioma. Suggest comparison with priors if available. There is associated local mass effect on the left anterior temporal and inferior frontal lobes at the operculum. No other lesions to suggest seizure focus. 2. Mild chronic small vessel ischemic disease.3. Dilated tubular structure involving the left parotid gland which is incompletely imaged but suspected to represent a dilated duct. Consider ultrasound or dedicated MRI of the parotid gland for further evaluation.