Tuberous sclerosis complex. There are multiple predominantly subcortical foci of T2 hyperintensity in the cerebral hemispheres. There are multiple subependymal nodules, the largest of which measures up to 8 mm in the region of the right foramen of Monro. There is extensive encephalomalacia in the right temporal lobe and left cerebellar hemisphere volume loss. There is also an area of low T2 signal that may represent prior hemorrhage associated with encephalomalacia in the right thalamus. There is no evidence of acute infarct. The ventricles are unchanged in size and configuration. The major cerebral flow voids are intact. There are postoperative findings in the right skull. The orbits, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
1. Extensive stigmata of tuberous sclerosis complex including multiple areas of cerebral dyplasia and subependymal nodules, but no evidence of obstructive hydrocephalus.2. Areas of encephalomalacia in the right temporal lobe and thalamus with crossed cerebellar diaschisis, but no evidence of acute infarction.