 There is some progression of myelination compared to the prior MRI study, but myelination remains immature compared to what is expected for age. Single voxel spectroscopy was performed separately in regions of predominantly gray matter and predominantly white matter, including the white matter that is visually abnormal on FLAIR sequence. Spectra from both tissue types show nonspecific reduced choline and questionable decreased NAA peaks.There is evidence of diffuse white matter loss especially in the periventricular region. The corpus callosum remains thin. There is a small cyst at left caudothalamic groove, which is stable from prior study and may represent a congenital anomaly or remote injury. The lateral ventricles and third ventricle remain prominent especially involving atria and occipital horns (right greater the left). Note is made of a cavum septum pellucidum and cavum vergae. These findings are without significant change from prior study.No diffusion-weighted abnormalities are identified. There is no evidence for intracranial hemorrhage. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. There are no extraaxial fluid collections. Flow voids are present within the major vessels indicating patency. The paranasal sinuses and mastoid air cells are clear.
1.Myelination has progressed compared to prior exam, but remains immature compared to what is expected for age.2.Stable prominent lateral ventricles and third ventricle, especially involving atria and occipital horns (right greater the left). 3.Spectroscopy data shows a nonspecific pattern of decreased choline and questionable decreased NAA, which may reflect sequelae of tissue injury or or abnormal development.