 There is a nodular focus measuring up to 17 mm in maximal dimension along the lateral aspect of the left lateral ventricle atrium, which is isointense to gray matter on all sequences without enhancement.There are scattered foci of T2 hyperintensity within the periventricular and subcortical white matter without mass effect, restricted diffusion, susceptibility and rounded, or enhancement.The ventricles and sulci are normal in size. The cerebellar tonsils are in normal position. There is no mass effect or midline shift. The pituitary gland is normal in size. There is no evidence for intracranial hemorrhage or acute cerebral, brainstem or cerebellar infarction. No diffusion-weighted abnormalities are identified. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. Mucosal thickening within specific secretions is noted within posterior ethmoid air cells. The remaining paranasal sinuses and mastoid air cells are clear. There is no abnormal enhancement within the brain. Coronal images of the temporal lobes demonstrate the temporal horns, hippocampal formations and parahippocampal gyri to be normal in morphology bilaterally without signal abnormalities, masses, or abnormal enhancement identified within the medial temporal lobes on either side. There is no evidence of mesial temporal sclerosis.
1.There is a focus of nodular gray matter heterotopia along the lateral aspect of the left lateral ventricle atrium.2.Nonspecific scattered foci of T2 hyperintensity are present within the periventricular and subcortical white matter. The differential diagnosis would most likely include small vessel disease, migraine sequelae, or less likely demyelinating disease.