HSV encephalitis

Gyriform restricted diffusion on DWI involving left insular cortex and medial temporal cortex (not well evident on any other sequences) – likely suggestive of acute hsv encephalitis with unilateral  involvement versus limbic encephalitis

 Differential considerations also include:- hyperacute MCA territory infarct in the given clinical settings  

 No evidence of significant mass effect or mid line shift.