Findings:
Areas of FLAIR/T2 hyperintensity are noted involving the left cingulate gyrus, the left parahippocampal gyrus and to a lesser extent the right parahippocampal gyrus, the left lingual gyrus, the left cerebral peduncle, the tegmentum of the pons, the anterior aspect of the pons, the superior cerebellar peduncles the right middle cerebellar peduncle. These areas show moderate diffusion restriction. No associated hemorrhage. No mass effect.
The ventricles and sulcal spaces are within normal limits. No midline shift.
The pituitary gland is normal.
The orbits, paranasal sinuses and mastoid air cells are clear.
No bony abnormality is seen.
Impression:
Abnormal high signal intensity in T2W and FLAIR sequences involving the parahippocampal gyri, the left cingulate gyrus, the midbrain and pons as well as the cerebellar peduncles, suggestive of inflammatory process, DDX herpes encephalitis. Further evaluation with CSF analysis and further follow-up is advised