Abnormal high FLAIR signal in the right parietal lobe and cingulate gyrus medially with positive mass effect and cortical involvement, which extends anteriorly into the frontal lobe, and into the posterior limb of the internal capsule. The posterior body and splenium of the corpus callosum also appear to be involved, and high FLAIR signal abnormality crosses the midline.
Central in the FLAIR signal abnormality is a large area of susceptibility artifact with few adjacent punctate areas, shown to be calcification on the previous CT brain.
Wispy peripheral enhancement is most conspicuous at the posterior end of the cingulate gyrus.
MRS through the FLAIR signal abnormality demonstrates reversal of the Cho:Cr and depression of NAA peaks. Increased lipid/lactate peaks are also seen.
MR perfusion demonstrates mildly elevated CBV in the right parietal high FLAIR signal deep white matter.