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An ill-defined defined irregularly-shaped area of FLAIR hyperintensity measuring up to 5 cm in the left parietal temporal white matter extends from the subcortical/juxtacortical white matter to the ventricular surface, with relative sparing of overlying cortex. Relatively mild local mass-effect with prominent linear traversing vessels that are radially oriented from the ventricular surface. A punctate focus of micro haemorrhage is noted at its medial margin. This lesion demonstrates peripheral diffusion restriction with central T2 shine through. The diffusion restricting rim correlates with increased CBV and the rim of fine linear and nodular enhancement. Central fine linear and nodular enhancement corresponds to the linear traversing vessels on SWI. At the superolateral posteromedial margin are several slightly larger round nodules of enhancement. MR spectroscopy demonstrates prominent elevated lipid-lactate, elevated choline and reduced NAA.
No other lesion identified, with the 2 apparent nodules of enhancement at the left temporal pole thought to be more likely phase artefact.