4. Diagnostic Imaging - MRI repeated

  • T2 MRI image, axial
    vascular/meningeal enhancement
    T2 MRI image, axial
  • Fluid attenuated T2 MRI image, axial
    CSF is dark, edema/inflammation is bright
    Fluid attenuated T2 MRI image, axial

Diagnostic Imaging - MRI interpretation


  • unilateral temporal involvement on the right
  • T2 hyperintensity in cortical white matter
  • gyral enhancement after gadolinium
  • sparing of basal ganglia
  • vascular and meningeal enhancement
  • cytotoxic edema pattern

…an infectious etiology (encephalitis) should be considered the most likely possibility. This pattern is less likely to be due to an ischemic insult and is unlikely to represent a tumor.

Breakpoint #4

  • How would you proceed at this point?