Reason: 3T scanner History: s/p epilepsy surgery. There is a rim of susceptibility along the margins of the previously seen post ablation area, corresponding to the prior prominent peripheral enhancement along the mesial left temporal lobe along the left hippocampus and amygdala, with a more conspicuous rounded focus of susceptibility along the anterolateral margin on the left side. Mild heterogeneous T2 signal is seen in the location of previous ablation. There is minimal residual ill-defined peripheral enhancement consistent with expected evolution of postoperative changes. The area of residual peripheral enhancement measures 9 x 24 mm compared to previous 12 x 22 mm. The previous laser fiber tract is also visualized via a left posterior parietal temporal approach with trace susceptibility along its, as well as focal rounded susceptibility in the left periatrial region. The ventricles and basal cisterns are stable in size and configuration. There is no midline shift or mass effect. Known new area of abnormal signal is seen. There is no extra axial fluid collection. No diffusion abnormalities appreciated. Faint rounded area of subtle enhancement suggested along the ventral pons likely represents a capillary telangiectasia. Lobulated mucosal retention cyst is present in the left maxillary sinus. Additional left sided trephination holes are also noted.
Interval expected evolution of previously seen postoperative changes from repeat laser ablation of the left hippocampus and portion of the amygdala. 