Male, 65 years old, status post seizure with left head deviation and convulsions. Again seen is an area of T2/FLAIR hyperintensity involving the subcortical white matter of the lateral/inferior aspect of the right precentral gyrus. Again noted are small foci of T2 hyperintensity extending medially towards the deep white matter. There is mild prominence of the adjacent perivascular spaces.No significant associated mass effect is detected. No definite associated volume loss. No diffusion restriction or significant susceptibility effect is noted. Elsewhere, brain parenchymal morphology is within normal limits. There are a small number of additional scattered foci of T2 hyperintensity in the cerebral hemispheres which are nonspecific. No acute intracranial hemorrhage or any abnormal extra-axial fluid collection is detected. The ventricular system is normal in size and morphology. A cystic foci in the nasopharynx are compatible with mucous retention cysts versus Tornwaldt's cyst. There is mild mucosal thickening involving the paranasal sinuses. Calvarium and extra cranial soft tissues are otherwise unremarkable.
Again seen is an area of T2/FLAIR hyperintensity in the right lateral precentral gyrus which is unchanged from 2/12/2016. No associated enhancement is appreciated. No significant mass effect or volume loss is detected. Differential remains gliosis from prior injury such as ischemia, cortical dysplasia, and less likely low grade neoplasm. If an old MRI is available, it would help narrow the differential. Alternatively would suggest short term follow-up in 1-2 months and longer term follow-ups if the lesion remains stable. 