Pre-op planning for biopsy: left sided progressive weakness and concern for encephalopathy. There is mild swelling and T2 hyperintensity involving the majority of the right frontal lobe cortex most conspicuous involvement along the right lateral frontal lobe, perisylvian region, and insula. There is also diffuse abnormal signal and edematous appearance of the mildly enlarged right thalamus and basal ganglia. There is no abnormal intracranial enhancement. 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 orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
Preoperative planning MRI for biopsy of extensive right cerebral hemisphere grey matter abnormality.