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Mild diffuse uniform atrophic changes of the left cerebral hemisphere manifested as deepening of cortical sulci and mildly decreased volume of cortex and white matter. This is associated with mild exvaccu dilatation of the left lateral ventricle. Mild diffuse T2 and FLAIR hyperintensity is noted affecting the white matter of the left cerebral hemisphere. Mild attenuation of the left middle cerebral artery is also noted.
Preserved volume and MRI features of both cerebellar hemispheres.
The described features of this case, as well as the clinical presentation of seizures, are suggestive of Rasmussen's encephalitis. It is believed to be a chronic viral infection of the brain affecting only one hemisphere with unilateral cerebral hemiatrophy resulting in drug-resistant epilepsy, and progressive neurological and cognitive deterioration.
Differential diagnosis of similar brain morphology: