New onset seizure since summer 2014. Seizure 2 protocol. No intracranial mass or mass effect. There is no midline shift or herniation. No evidence of acute infarct or hemorrhage. The bilateral hippocampi are symmetric in size and signal without evidence of mesial temporal sclerosis. There is mildly diffuse pachymeningeal enhancement. No associated brain sagging or extra-axial collections to suggest intracranial hypotension. There are scattered foci of abnormal T2/FLAIR hyperintensity within the periventricular and subcortical white matter, which are nonspecific, but most consistent with minimal chronic small vessel ischemic changes. The ventricles and basal cisterns are normal in size and configuration. The skull and extracranial soft tissues are unremarkable. A Tornwaldt cyst is incidentally noted in the nasopharynx.
1. No intracranial mass or mass effect. No findings to suggest seizure focus are appreciated.2. Mild smooth diffuse dural enhancement which is nonspecific and may be related to recent lumbar puncture or prior subdural collection for example. No associated brain sagging or extra-axial collections to suggest this is related to intracranial hypotension..I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.