Long term herpes encephalitis sequelae
History of HSV about years ago. Presenting with progressive language and memory deficits.
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Bilateral mesial temporal/hippocampal encephalomalacia (left > right) extending also to the anterior poles of the temporal lobes and left insular region, unchanged since the last scan six year-ago.
Otherwise, cerebral volume is age appropriate. No evidence of restricted diffusion or other brain abnormality. Ventricles and basal cisterns are unremarkable.
This patient has a documented history of herpes simplex virus encephalitis. On the current scan, sequelae of brain parenchyma loss are demonstrated bilaterally involving the temporal lobes and mesial temporal regions.
The sequelae, although non-specific in appearances, have a typical distribution for this type of encephalitis.