Focal cortical dysplasia - type II
Long-standing seizures, epileptogenic lesion?
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There is a focal juxta-cortical white matter T2/FLAIR hyperintensity in the left frontal lobe at the bottom of the inferior frontal sulcus with an associated thin linear increased T2/FLAIR signal extending from the apex of the lesion to the lateral ventricle ependymal surface (transmantle sign). Overlying cortex is thickened with a blurring of the grey-white interface. Small focus of white matter increased T2/FLAIR signal deep to the right cingulate gyrus region is nonspecific and of uncertain clinical relevance. The grey-white matter junction and appearance of the cortex is otherwise unremarkable, with no evidence of grey matter heterotopia. No intra or extra-axial mass or collection identified. The mesial temporal lobes, including the hippocampi, are unremarkable in size, signal and morphology.
The imaging features favor left frontal lobe type II cortical dysplasia.