Findings:
The left-sided mesial temporal parenchyma is noted crawling on the edge of the tentorium and settling subtentorial in the left ambient cistern. No obvious signal abnormality of the imaged brain parenchyma. No midline shift or hydrocephalus.
The vestibular-cochlear apparatus and internal acoustic canals have a normal appearance. No structural cochlear abnormalities.
The facial and vestibulocochlear nerves have a normal appearance, with no focal lesion and no signal abnormality. No CPA mass lesion.
Partial obliteration of the mastoid air cells is seen on the right side. The imaged paranasal sinuses are clear.
Conclusion:
No evidence of CPA mass lesion.
Partial obliteration of the mastoid air cells on the right. Further evaluation with CT petrous bones is advised.
Left uncal herniation, without obvious mass lesion in the imaged brain, possibly in keeping with idiopathic gyral herniation. Further evaluation with MRI haed is advised.