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A lesion comprising of a cluster of cortical and subcortical cysts in the right inferior subcentral gyrus and operculum demonstrate no enhancement and no calcification or blood products. The cysts attenuate fully on FLAIR but are embedded in a region of increased T2 signal. Diffusion demonstrates facilitated diffusion of both the presumed fluid component and the intervening tissue.
The differential diagnosis is primarily between a low-grade tumour (DNET, gangliocytoma, ganglioglioma) and a cluster of perivascular cysts. The presence of intractable seizures favours the former.
An MVNT is a possibility although the cysts are usually smaller and do not attenuate on FLAIR.