Magnetic resonance (MR) and computed tomography (CT) imaging of temporal lobe encephalocele-associated epilepsy: a pictorial review.

Temporal lobe encephaloceles (TLENs) are herniations of brain tissue through defects in the dura, often associated with conditions including elevated intracranial pressure, trauma, cerebrospinal fluid leak, and epilepsy. TLENs are frequently underdiagnosed, particularly in epilepsy patients, due to their subtle appearance on imaging and their location in the middle cranial fossa, delaying the diagnosis of this surgically treatable condition. This pictorial review will focus on the typical imaging appearance of TLENs in epilepsy patients, classic and unusual locations of TLENs associated with epilepsy, and related imaging features, such as those of idiopathic intracranial hypertension. We will also discuss some challenges and pitfalls that may lead to misdiagnosis and consider the tools and techniques which may help confirm the diagnosis.