Case Notes
History
32 year old male presenting with episode of staring and unresponsiveness. His head turned to the right and then he fell.Exam
MR diffusion
Prior Study
CT Head was not available.MR T1-w exam pre and post contrast
There developmental heterotopic gray matter in the posterior right frontal lobe.
Abnormal left hippocampus with evidence of post seizure hyperacute changes involving all portions of the left hippocampus.
There is abnormal contrast enhancement centered in the transistion zone between the body and tail on the right. This could represent acute post seizure dysautoregulation, or could represent tissue necrosis-significance is indeterminate on only the post contrast T1-w sequence.
T2-w MR
There is evidence of hyperacute post seizure left hippocampal edema involving all subsegments of left hippocampal segments. The right hippocampus appears normal.
There is developamental heterotopic posterior frontal gray matter and focal left parietal atrophy with left ventricular trigone dilatation and adjcent deep parietal leukomalacia.