Spastic quadriplegic with history of cerebral palsy and TORCH infection. Evaluate for seizure focus or cerebellar lesion: horizontal nystagmus. There are extensive areas of cystic encephalomalacia within the bilateral parietal and posterior frontal lobes, with associated scattered areas of susceptibility effect, marked thinning and bulging of the body of the corpus callosum, and ex-vacuo dilatation of the lateral ventricles. There are also smaller areas of encephalomalacia and susceptibility effect in the bilateral basal ganglia. There are multiple additional scattered small foci of abnormal susceptibility throughout cerebral hemispheres bilaterally. There is diffuse prominence of the cerebellar sulci, left more than right. There is also patchy T2 hyperintensity in the left cerebellar hemisphere white matter. There is no evidence of acute infarction. There is no intracranial mass lesion or midline shift. The cranium has a microcephalic appearance and there appears to be hypertelorism. There is mild scattered paranasal sinus mucosal thickening.
1. Areas of chronic hemorrhagic infarction in the bilateral cerebral hemispheres, particularly the frontal and parietal lobes and basal ganglia, as well as multiple scattered cerebral calcifications are compatible with the history of cerebral palsy and of TORCH infection.2. Diffuse left greater than right cerebellar volume loss and patchy signal abnormality in the left cerebellar hemisphere white matter may be related to the supratentorial infarcts with superimposed crossed cerebellar diaschises.  I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.