Demographics:
22 years old, Male
Indication:
Epilepsy with increasing frequency of seizures
Findings
- T2/FLAIR signal hyperintensity in the right parahippocampal gyrus and in the adjacent right fusiform gyrus with mild gyral expansion
- No associated enhancement, restricted diffusion, or susceptibility artifact
- No evidence of acute infarct, hemorrhage, or hydrocephalus
- Mild mucosal thickening of the paranasal sinuses without fluid levels
Diagnosis
Low grade glioma vs encephalitis
Sample Report
Expansile, T2/FLAIR hyperintense lesion in the right parahippocampal gyrus and in the adjacent right fusiform gyrus, which could represent viral encephalitis (including herpes encephalitis), edema related to recent seizure activity, or a low-grade glioma. If there is clinical concern for infectious encephalitis, recommend presumptive treatment awaiting CSF analysis. Recommend short interval follow-up imaging to monitor for signal resolution in order to rule out neoplasm.
No evidence of acute infarct, hemorrhage, or hydrocephalus.
Discussion