Intractable epilepsy. Many of the images are degraded by patient motion. There are findings related to right frontal craniotomy and right frontal cortical resective surgery. There is a 15 mm wide extra-axial fluid collection deep to the craniotomy flap. There is extensive T2 hyperintensity surrounding the resection cavity and extending across the midline along the corpus callosum. There is blurring of grey-white matter differentiation along the right superior frontal sulcus adjacent to the surgical margin. There is associated mild midline shift to the right and ex vacuo dilatation of the right lateral ventricle. The hippocampi are grossly unremarkable. There is no evidence of acute intracranial hemorrhage, mass, or acute infarct. The orbits are grossly unremarkable.
Findings related to right frontal cortical resective surgery with extensive T2 hyperintensity surrounding the resection cavity and extending across the midline along the corpus callosum may represent encephalomalacia and/or gliosis. Superimposed edema related to seizure activity and perhaps underlying areas of cortical dysplasia are potential considerations as well.