Clinical question:? Bleed or mass effect. Signs and symptoms: Seizure Nonenhanced CT of brain:The images through the anterior aspect of the temporal lobes demonstrate a subtle area of low attenuation in the left anterior temporal lobe. This is within the white matter and mid no distinct involvement of cortex. There is also extensive beam hardening artifact secondary to bone. Recommend follow-up exam with an MRI for better evaluation. The finding could represent edema from an inflammatory process (viral encephalitis), masse, venous thrombosis or other causes. I cannot be entirely certain if this finding is not an artifact or represent a focal area of encephalomalacia of unknown etiology. Considering provided clinical history of seizure further MR is recommended.The density and morphology of brain is otherwise entirely within normal limits. The cortical sulci, ventricular system and all CSF cisterns as well as gray -- white matter differentiation is preserved. The density of intracranial venous sinuses show no definitive abnormality.Calvarium, limited real paranasal sinuses, orbits and mastoid air cells are unremarkable.
1.Subtle suspected area of edema in the white matter of the left anterior temporal lobe as detailed above. Follow-up wirth and MRI is recommended if patient's symptoms persist. Please see above comments as for etiology.2.this examination is otherwise unremarkable.