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WebEarly patchy peripheral enhancement that becomes intense, continuous, and thickened with time; Inner rim of enhancement tends to be quite smooth, helping to differentiate from the irregular enhancement in the necrotic center of high-grade tumors; MRS WebNoncontrast CT may be normal in the early stage of HSE, or an abnormality may be very difficult to detect, in part due to beam-hardening artifact obscuring the medial temporal lobes. ... Gyriform or patchy enhancement may also be seen at this stage secondary to blood-brain barrier breakdown. In chronic stages, encephalomalacia and gliosis ... notifying ofsted of change of manager

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