Anterior temporal lobe perivascular space
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Cystic anterior temporal lobe lesion closely related to middle cerebral artery branch has some surrounding edema which although would be unusual for perivascular spaces elsewhere within the brain is well described in this location. Features are characteristic of an anterior temporal lobe perivascular space.
Anterior temporal lobe perivascular spaces are relatively recently described and are fairly frequent with characteristic appearances allowing for a confident diagnosis to be made avoiding surgery.
This patient has been followed up with yearly MRIs for 5 years now, with no change whatsoever.