Clinical and radiological aspects of bilateral temporal abnormalities: pictorial essay

The temporal lobes are vulnerable to several diseases, including infectious, immune-mediated, degenerative, vascular, metabolic, and neoplastic processes. Therefore, lesions in the temporal lobes can pose a diagnostic challenge for the radiologist. The temporal lobes are connected by structures such as the anterior commissure, corpus callosum, and hippocampal commissure. That interconnectedness favors bilateral involvement in various clinical contexts. This pictorial essay is based on a retrospective analysis of case files from a tertiary university hospital and aims to illustrate some of the conditions that simultaneously affect the temporal lobes, as well as to define some neuroimaging elements that may be useful for the differential diagnosis of these diseases. Using computed tomography and magnetic resonance imaging scans, we illustrate the neuroradiological findings in confirmed cases of human herpesvirus 1, central nervous system tuberculosis, autoimmune encephalitis, Alzheimer's disease, frontotemporal dementia, mesial temporal sclerosis, stroke, kernicterus, megalencephalic leukoencephalopathy with subcortical cysts, low-grade glioma, and secondary lymphoma, the objective being to emphasize the importance of these imaging methods for making the differential diagnosis.