12 year old male with intractable epilepsy, evaluate for structural abnormality A small focus of susceptibility-weighted artifact is seen within the right corona radiata (image 43, series 8). There is no other perilesional signal abnormality. A second subcortical focus is present in the inferior right temporal lobe (image 21, series 5) which is T2 hyperintense and T1 hypointense. Neither lesion demonstrates associated mass effect. No diffusion restriction is seen to suggest acute ischemia. The CSF spaces are appropriate for the patient's stated age with no midline shift. The ventricles are normal in size and shape. Normal vascular flow voids are present in the major intracranial vasculature. The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.Nonspecific focus of susceptibility artifact in the right corona radiata may represent prior micro-hemorrhage, residua from prior trauma, or a small cavernoma. Given the patient's age, hemorrhagic metastasis is considered unlikely.2.Right temporal lobe T2 hyperintense T1 hypointense focus is favored to represent a neuroglial cyst or prominent perivascular space.3.Follow-up 3T MRI brain with contrast is recommended in 3 months to evaluate for stability.