4 y/o ex-26 week M with no significant PMH who presents with new onset seizure without any inciting factors on history and without concern on physical examination. Please evaluate for structural brain abnormality, mass, or evidence of prior insult History: first time seizure lasting 8 minutes per parental report, sounds generalized tonic clonic per history. Brain parenchyma appears within normal limits. There is mild prominence of the perivascular spaces in the periatrial region which is a normal variation. There is minimal nonspecific FLAIR hyperintensity in the adjacent posterior periventricular white matter. There is no significant parenchymal signal abnormality. No restricted diffusion to suggest acute ischemia. No intracranial hemorrhage. No intracranial mass or mass-effect. The ventricles are within normal limits in size and configuration. Major flow-voids are preserved. Sella and orbits are grossly within normal limits. There is moderate opacification throughout the paranasal sinuses. There is also diffuse right mastoid opacification. Bone marrow signal and extracranial soft tissues are otherwise within normal limits.
1. Brain parenchyma appears within normal limits. Specifically, no findings to suggest seizure focus are appreciated.2. Diffuse opacification of the paranasal sinuses as well as the right-sided mastoid air cells, which can be correlated with clinical findings.