 There is asymmetric increased signal in the left hippocampus in the FLAIR images. There is loss of the internal architecture of the left hippocampus and the left temporal horn is slightly asymmetrically prominent. The left temporal lobe cortex appears slightly greater in signal overall than the right, although this may be artifactual.No diffusion or susceptibility abnormalities. The ventricles and sulci are prominent. There is no midline shift. The gyri and the sulci are not thickened. No evidence of bleed, edema, or mass effect. There is normal gray-white matter differentiation. Myelination appears normal. There is scattered mucosal thickening in the sinuses and fluid is seen in the mastoids.Flow voids of the cerebral arteries and the visualized internal carotid arteries appears normal.
Asymmetrically increased FLAIR signal in the left hippocampus with loss of the internal architecture, with mild volume loss at this time, consistent with left mesial temporal sclerosis.