Reason: left temporal hypodense lesion History: seizure The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a hemorrhagic lesion present in the left temporal lobe located in the fusiform gyrus and extending underneath the temporal horn of the left lateral ventricle. The lesion itself abuts the temporal horn of the right lateral ventricle. The temporal horn of left lateral ventricle is narrowed and displaced superiorly. The hemorrhagic focus is low signal on susceptibility imaging and has blooming effect. There is heterogenous signal hyperintensity on FLAIR and T2 imaging surrounding the 5mm focus of hemorrhage. The T2/FLAIR signal change measures 52 x 40 mm axial dimensions and involves left fusiform gyrus and left parahippocampal gyrus. There is associated heterogenous and ring like contrast enhancement measuring 23x33mm axial dimensions. There is no convincing evidence for diffusion restriction. There are some small serpiginous low signal foci on susceptibility imaging within this lesion. No ependymal enhancement is identified on the current exam.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.Examination is degraded by motion artifact.
1.Findings are suggestive of neoplasm in the left temporal lobe. The serpiginous signal voids are suggestive of microvascularity which in the case of a primary brain tumor would support a higher grade lesion.