Loading Stack -
0 images remaining
There is subtle T2 hyperintensity in the right mesial temporal lobe, particularly involving the hippocampus, with corresponding abnormal diffusion restriction. Both T2 hyperintensity and diffuse restriction extends into the right thalamus.
No enhancing cerebral mass lesion. Sulcal and ventricular pattern is within normal limits. No susceptibility blooming. Periventricular and multiple punctate deep white matter T2 hyperintensities, out of keeping in number for patient's age, in keeping with chronic small vessel ischaemia.
Conclusion: T2 hyperintensity with diffusion restriction in the right hippocampus and ipsilateral thalamus are likely seizure related.
The differential includes herpes encephalitis, in the context of acute onset symptoms, however the involvement of thalamus is atypical for HSV encephalitis as is the very limited involvement of just the hippocampus.