 There is diffuse T2 signal hyperintensity in the left slightly greater than right periventricular white matter and appears similar to prior MRI in 2012; findings compatible with periventricular leukomalacia and encephalomalacia. Diffusely diminished supratentorial white matter volume as well as thinning of the corpus callosum compatible with Wallerian degeneration, not significantly changed. The ventricles are normal in size. Cystic foci adjacent to the frontal horns favored to represent cystic encephalomalacia, less likely connatal cysts given similar appearance posteriorly. The cisterns remain patent. There is no midline shift or mass effect. There are no other areas of abnormal signal or pathological enhancement. No evidence of heterotopia or migrational anomaly. Bilateral hippocampi are symmetric in size and signal characteristics. There is no diffusion abnormality. No extra-axial fluid collection is identified. Normal flow-voids are demonstrated in the major intracranial vascular structures.
1.No significant change in extensive periventricular T2/FLAIR signal abnormality, periventricular cystic changes, and diminished supratentorial white matter volume. Findings are again consistent with periventricular leukomalacia/encephalomalacia related to remote injury.2.No intracranial mass, acute infarct, or hemorrhage. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.