Right frontal mass and seizures. There is a peripherally enhancing mass in the right frontal lobe that measures up to approximately 3.5 cm with extensive surrounding T2 hyperintensity. There is associated partial effacement of the right lateral ventricle, mild subfalcine herniation, and approximately 10 mm of midline shift to the left. There is also an area of encephalomalacia in the left parietal region and extensive non-enhancing cerebral white matter T2 hyperintensity. There is no evidence of acute infarct or intracranial hemorrhage. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable. There is fluid within the left mastoid air cells and middle ear cavity.
1. A peripherally enhancing mass in the right frontal lobe that measures up to approximately 3.5 cm with extensive surrounding T2 hyperintensity may represent a primary or metastatic tumor with associated vasogenic edema, versus less likely an atypical abscess. 2. Chronic small vessel disease and left parietal lobe infarct.3. Findings suggestive of left otomastoiditis.