24 years, Male, vision loss. There is diminished parenchymal volume centered in the right occipital lobe which is replaced with a cystic cavity that communicates with the right lateral ventricle most suggestive of porencephaly. There is however mild FLAIR hyperintensity within this region suggesting gliosis/encephalomalacia. There is deformity of the overlying gyri favored to represent volume loss related to same injury. There is irregularity involving the cortex of the superior frontal gyrus abutting the superior frontal sulcus, axial T2 image 28, suggesting polymicrogyria but can be better assessed with high-resolution 3-D T1 sequences on 3 Tesla.The splenium of the corpus callosum is small favored to represent Wallerian degeneration. There is mild nonspecific T2/FLAIR hyperintensity involving the periventricular white matter. No evidence of intracranial mass effect, midline shift, or herniation. No hydrocephalus. No evidence of acute ischemia or recent hemorrhage. No abnormal enhancement. Major flow-voids are preserved. Pituitary gland and infundibulum are grossly unremarkable. Extracranial soft tissues are also grossly unremarkable.The optic nerves and chiasm appear small in volume without focal signal abnormalities. Bilateral orbits appear otherwise unremarkable. No masses or abnormal enhancement within the orbits.
1. Findings are most compatible with sequela of prenatal injury centered in the right occipital lobe where there is a porencephalic cavity communicating with the lateral ventricle.2. Question of polymicrogyria adjacent to the right superior frontal sulcus. Suggest high resolution 3D T1 sequence at 3 Tesla to better assess cortical abnormalities.3. Diminutive caliber of the bilateral optic nerves and chiasm.