Clinical question: Preop planning. Signs and symptoms: Seizures. Pre- and post enhanced fusion brain MRI:Examination is performed as a surgical/treatment planning study and is not a true diagnostic exam.Examination demonstrate placement of electrodes in the left anterior temporal lobe. Electrodes enter the calvarium via a left posterior temporal-occipital burr hole as well as a left frontal burr hole. Electrodes are noted along the medial aspect of the left anterior temporal lobe and extending posteriorly along the medial aspect of the left mid and posterior temporal. Additional electrodes traverses the left anterior temporal. The appropriateness of the placement of the electrodes should be decided by the referring clinical physician. There is a small focus of T2 hyperintensity of the brain parenchyma at the site of entry of an electrode in the left posterior temporal-occipital region measuring approximately 14 x 20 mm and believed to represent a focus of edema.Examination is performed for surgical planning and does not include axial T1 nonenhanced series and there is also metallic streak artifact secondary to electrodes which makes precise assessment for detection of abnormal enhancement difficult. Within this limitation however no definitive evidence of abnormal enhancement is detected.Ventricular system remains within normal size and with maintained midline.
1.Surgical planning exam demonstrate a series of electrodes in the left temporal lobe as detailed.2.No convincing evidence hemorrhage or of abnormal enhancement.3.Tiny focus of parenchymal edema at the site of entry of the electrodes in the left posterior temporal lobe measuring at 14 x 20 mm in size.