 There is a small 8 x 13 mm focal oval CSF signal intensity structure along the anterior lateral aspect of the left temporal horn. There appears to be minimal mass effect on the adjacent hippocampus with possible associated volume loss of the left hippocampus relative to the right. Additionally, there is mild prominence of the left trigone and atrium, which is of unknown clinical significance. Overall, there is mild to moderate prominence of the ventricles and sulci consistent with age related volume loss. Mild peri-ventricular and subcortical white matter T2/FLAIR signal abnormality consistent with chronic small vessel ischemic disease. No diffusion restriction to suggest ischemia. There is no midline shift. There are no extra-axial fluid collections or subdural hematomas. The cerebellar tonsils are in normal position. Flow voids are present within the major vessels indicating patency.
Small focal oval CSF signal along the anterolateral aspect of left temporal horn which may relate to coaptation of ependymal surfaces forming a pseudo-lesion, versus a true ependymal cyst given slight mass effect on the adjacent hippocampus. Possible associated mild volume loss of the left hippocampus, although thin section imaging not available. 