84 years, Male, left frontal lesion, altered mental status, recent seizure. Limited sequences were obtained as patient could not tolerate the full study including the postgadolinium sequences.There is a masslike lesion involving the left superior frontal gyrus measuring 3.3 x 2.4 cm with T1 and T2 hyperintensity and peripheral rim of low T2 signal. Finding is favored to represent a subacute hematoma. There is associated diffusion restriction.There is moderate global parenchymal volume loss. There is prominence of the extra-axial spaces along the bilateral cerebral convexities likely related to combination of volume loss and bilateral subdural hygromas without local mass effect. There are scattered foci of T2/FLAIR hyperintensity in the periventricular and subcortical white matter which are nonspecific but compatible with chronic small vessel ischemic disease. There is ex vacuo dilatation of the left lateral ventricle. No hydrocephalus. No midline shift or herniation. There is mild soft tissue swelling in the right periorbital region.
1. Limited study due to motion degradation, limited sequences, and absence of gadolinium. 3.3 x 2.4 cm masslike lesion in the left frontal lobe is most suggestive of a subacute intraparenchymal hematoma, but would suggest complete brain MRI study with gadolinium for further evaluation and exclude a potential underlying lesion.2. Bilateral subdural hygromas without significant mass effect.3. Mild chronic small vessel ischemic disease.