Male, 21 years old, with seizures and developmental delay. Evaluate for seizure focus. A small area of gray matter thinning with underlying T2 hyperintensity is seen within the right frontal lobe (see key images). There is no associated mass effect or pathologic enhancement.No other areas of cortical irregularity, pathologic signal or abnormal enhancement are seen. Diffusion-weighted images are unremarkable. No intracranial hemorrhage or any abnormal extra-axial fluid collection is detected. The ventricular system is normal in size and morphology.Bone marrow signal characteristics are within normal limits. Mild paranasal sinus mucosal inflammation is seen.
A small area of gray matter thinning and underlying parenchymal T2 hyperintensity is seen within the right frontal lobe. This is favored to represent a cortical dysplasia, though the differential would also include sequelae of prior parenchymal injury. A neoplastic etiology is considered unlikely, though follow-up imaging is advised.