Case Notes
History
41 year old female with episodes of "weird feelings", staring, unresponsiveness and observed oral automatisms.Exam
MR diffusion
Prior Study
CT Head and precontrast T1-w scans were not available.Post contrast T1-w MR
Negative post contrast T1 weighted MR for foreign tissue lesion nor post seizure hyperemia.
There is asymmetric size (volume) of the hippocampi with the right side appearing larger than normal, and the left side appearing normal or less than normal volume.
T2-w MR
1. There is evidence of a recent seizure event with residual swelling of the right hippocampus but without persistent T2-w hyperintensity; findings are confined mainly to the body of hippocampus. This could represent a hyperacute mild seizure which fails to generate observable edema, or could be a seizure event in the acute phase with resolving edema.
2. The left hippocampal volume is reduced from expected normal, and there is actual tissue loss within the hilum. The myelinated tracts remain intact. These findings represent an early stage of MTS.