seizure, known right temporal lesion. Re demonstration of right parahippocampal gyrus lesion (16mm x 16mm x 19mm).The lesion appears to be exophytic nature and a bit expansile arising from mesial superior aspect of the parahippocampal gyrus likely involving subiculum and abuts dentate gyrus superiorly. On Gad infusion, the lesion shows minimal or no enhancement. Specifically, there is no nodular or mural enhancement.Mesial aspect of the lesion shows large tubular signal void which indicates right PCA passes by which is a fetal origin.Diagnostic possibilities include ganglioglioma, low grade glioma. Possibility of extra axial lesion would be less likely.The ventricles, sulci and cisterns are symmetric and unremarkable. There is no edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.
1. Minimally or no enhancing right parahippocampal gyrus mass lesion as described above. Diagnostic possibilities include gangioglioma, low grade astrocytoma or other low grade intra axial tumor. 2. No change of the lesion's MR characteristics and size since prior exam.