Male 41 years old Reason: EEG showing possible R-sided focal lesion History: Seizures. Linear areas of diffusion restriction are seen along the right precentral gyrus, right post central gyrus, as well as the left post central gyrus with involvement of the gray matter and relative preservation of the underlying white matter. There is no significant associated edema or mass effect. There is no evidence of intracranial hemorrhage or mass. The brain parenchyma and pituitary gland appear unremarkable. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
Fairly symmetric areas of diffusion restriction along the right precentral, right postcentral gyrus as well as left postcentral gyrus as detailed above. The differential includes an ischemic process, more likely to be related to a generalized perfusion deficit rather than an embolic process. Differential also includes a metabolic process, including hyperammonemia in the setting of renal or liver dysfunction. Findings may also be related to drug exposure or vasculitis. Findings discussed with Dr. Cunningham at 1000 on 10/24/2016.