Abnormal ill-defined T2 signal increases in the medial temporal lobe regions bilaterally and more superiorly in the inferior frontal lobe periventricular and caudate nuclei regions. There is also an abnormal T2 signal increase in the posterior limb of the left internal capsule, the right cerebral peduncle and right pons. Patchy contrast enhancement is seen in the medial temporal lobe regions bilaterally. There is mild restricted diffusion in the medial left temporal lobe. There is no appreciable mass effect. No extra-axial fluid collections are present. No other abnormality is noted.
IMPRESSION:
Bilateral temporal lobe and frontal lobe, right midbrain and right pons lesions are present, likely representing infectious encephalitis. Limbic encephalitis would also be considered in the appropriate clinical setting. Gliomatosis is considered unlikely.