Left upper temporal field cut. There is a somewhat infiltrative heterogeneously enhancing mass with areas of susceptibility effect centered in the right medial temporal lobe, with extension into the cerebral peduncle that measures at least up to 4 cm. There are several adjacent heterogeneously enhancing lesions in the right temporal, inferior parietal, and anterior occipital lobes. There is hazy confluent T2 hyperintensity surrounding all the lesions. There is effacement of portions of the right lateral ventricle, but dilatation of the right temporal horn. There is right uncal herniation and approximately 10 mm of midline shift to the left. There is no evidence of acute infarct. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
A mass centered in the right medial temporal lobe, with extension into the cerebral peduncle that measures at least up to 4 cm, with several satellite lesions likely represents a high-grade glial neoplasm. There is associated entrapment of the right temporal horn and 10 mm of midline shift to the left. 