Clinical question:Preop planning. Signs and symptoms: Epilepsy. Going for surgery. Pre- and post enhanced treatment planning MRI:Limited nonenhanced portion of the exam demonstrate a laser ablation device entering the calvarium via a left posterior temporal burr hole and tip of the device in the left hippocampus. No evidence of hemorrhage. Focus of T2 hyperintensity at the level of burr hole is again identified.Post enhanced images demonstrate patchy and linear enhancement extending from the left hippocampus posteriorly along the medial aspect of left anterior and mid temporal lobe along the course of the laser ablation device.Minimal dural thickening and enhancement at the level of the burr hole is also noted.Subtle dural thickening and enhancement along the left anterior temporal burr hole is also noted.Ventricular system remain within normal and without deviation of midline.
1.Placement of a laser ablation device entering from the left posterior temporal burr hole with the tip in the left hippocampus.2.Post enhanced images demonstrate patchy linear enhancement of the left hippocampus and extending posteriorly along the course of the laser ablation device as detailed.