 There is an infiltrating T2 hyperintense lesion within the left insular cortex and amygdala with mild associated mass effect. While measurements are difficult, it is unchanged in size compared with the 10/29/2014 exam with the amygdala portion measuring 14 mm in AP thickness and 18 mm in height. There is no associated elevated relative cerebral blood volume. There are a few scattered unchanged punctate foci of susceptibility effect within the left parietal lobe compatible with chronic microhemorrhages or cavernous malformations. There is a punctate focus of enhancement, diffusion restriction, T2 hyperintensity, and susceptibility effect within left post central gyrus that is unchanged compared with the 3/25/2015 exam and not present previously. There is no associated elevated relative cerebral blood volume and the pattern is most compatible with small vascular anomaly. There is no evidence of acute infarct. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The skull, paranasal sinuses, and scalp soft tissues are unremarkable.
Infiltrating nonenhancing lesion within the left insular cortex and amygdala is unchanged dating back to at least October 2014.