Male, 2 years old, with sensorineural hearing loss status post meningitis. Brain MRI:The ventricles and sulci are mildly, diffusely prominent, consistent with global volume loss, greater than expected for the patient's stated age, however unchanged in extent. The cisterns remain patent. There is no midline shift or mass effect. There are no areas of abnormal signal or pathological enhancement. No leptomeningeal or pachymeningeal enhancement is appreciated. There is no diffusion abnormality. No extra-axial fluid collection is identified. Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. IAC MRI:There has been interval decrease in bilateral pathologic enhancement of the cochlea, vestibules, and to a lesser degree the semicircular canals. The inner ear structures otherwise demonstrate normal morphology and T2 signal characteristics. No mass lesion or pathologic enhancement is evident in the IACs or CP angles. The eighth cranial nerves are present bilaterally. Previously described questionable pathologic enhancement of portions of the bilateral facial nerves are unchanged, and are felt to be within normal anatomic variation for the appearance of post cisternal facial nerves.
1.The ventricles and sulci are mildly, diffusely prominent, consistent with global volume loss, greater than expected for the patient's stated age, however unchanged in extent. 2.There has been interval decrease in bilateral pathologic enhancement of the cochlea, vestibules, and to a lesser degree the semicircular canals,