Clinical question: Preop planning for brain lesion. Signs and symptoms: Headache and memory loss. Pre- and post enhanced Stealth brain MRI:Examination demonstrates extensive vasogenic edema in the left anterior and mid temporal lobe with resultant extensive effacement of regional cortical sulci and trace midline shift to the right. There is a necrotic rim-enhancing lesion in the left anterior and mid temporal lobe projecting lateral to the left temporal horn of ventricle. The lesion measures 25 mm in AP axis, 7 mm in transverse axis and 10 mm in cranial cephalad. No additional foci of edema or abnormal parenchymal/meningeal enhancement. Ventricular system remains within normal size
1.A thin rim enhancing lesion in the left anterior and mid temporal lobe white matter measuring 25 x 7 x 10 mm in size. There is extensive surrounding vasogenic edema with resultant trace deviation of midline to the right.2.No additional foci of edema or parenchymal/meningeal enhancement.