 No findings to suggest a seizure focus are appreciated. No evidence of cortical dysplasia, heterotopic gray matter, or loss of gray-white differentiation. There is no evidence of mass or acute infarct. There are no areas of abnormal parenchymal signal. The hippocampal formations are symmetric; normal in size and signal intensity. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. Borderline low-lying cerebellar tonsils are again seen measuring up to 3-4 mm below the foramina magnum on the right. The midline structures and craniocervical junction are otherwise normal. The major cerebral flow voids are intact. The skull and scalp soft tissues are unremarkable. There is paranasal sinus mucosal thickening most prominent in the maxillary sinuses where there is also a retention cyst.
1. No evidence for mass or structural abnormality to suggest seizure focus.2. Borderline low-lying cerebellar tonsils without clear evidence of Chiari 1. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.