Findings:
An area of encephalomalacia is seen in the right temporal lobe involving the parahippocampal gyrus, the middle and inferior temporal gyri and partially the superior temporal gyrus with minimal surrounding gliosis. Consequential mild dilatation of the right posterior and temporal horns as well as associated skull vault thickening in the right temporolateral region. No hydrocephalus or midline shift.
On the SWI sequence diffuse areas of blooming artefacts are seen in the area of encephalomalacia.
The brain parenchyma is otherwise unremarkable. No diffusion restriction.
Coronal T 2 -weighted images show mild protrusion of the CSF within the right mastoid, in keeping with a small temporal meningocele.
There is minimal protrusion of the left mesial temporal parenchyma into the left ambient cistern, in keeping with mild idiopathic gyral herniation.
On the arterial TOF sequence faint flow signal is seen within one M2 branch on the right, suggestive of stenosis. The Circle of Willis is normal without evidence of any aneurysm.
The pituitary gland is normal.
The orbits, paranasal sinuses and mastoid air cells are clear.
The craniocervical junction is normal.
Conclusion:
Area of encephalomalacia involving the right temporal lobe, as described above, likely in keeping with perinatal right MCA territory infarct with associated gliosis and skull vault thickening.
Possible chronic stenosis of a M2 branch on the right. No aneurysm.
Small right temporal meningocele protruding into the right mastoid.
Mild idiopathic left uncal herniation.