The left temporal lobe is enlarged with increased T2 signal and areas of intrinsic high T1 signal with susceptibility artefact suggesting haemorrhagic foci. Heterogeneous patchy diffusion restriction. Minor contrast-enhancement, mostly cortical in location.
MR spectroscopy demonstrates increased lactate and decreased NAA and choline/creatine peaks. MR perfusion demonstrates mixed areas of increased and decreased perfusion.
Left temporal horn is effaced. No hydrocephalus. Left-to-right-midline shift of 4.5 mm. Mild left uncal herniation.