3 years, Female, seizure, follow-up previous study. Again seen is asymmetric enlargement of the right lateral ventricle. There is also suggestion of subtle asymmetrically increased parenchymal volume in the right cerebral hemisphere, as compared to the left. The right caudate head and putamen also appears slightly larger. There is evidence of mild diffuse loss of white matter volume, particularly in the right cerebral hemisphere. There is also diffuse thinning of the corpus callosum as seen before. Myelination has progressed since prior study. Subtle areas of subcortical FLAIR hyperintensity however persist including the left frontal and right greater than left temporal subcortical white matter presumably related to incomplete myelination. Hippocampi are symmetric and grossly unremarkable. No restricted diffusion to suggest acute ischemia. No intracranial hemorrhage. No intracranial mass or mass-effect. Major flow-voids are preserved. Moderate opacification of the paranasal sinuses is noted and nonspecific.
1. Again seen is diffuse thinning of the corpus callosum as well as mild diffuse white matter volume loss, particularly in the right cerebral hemisphere. The right cerebral hemisphere appears overall asymmetrically larger in volume. The right lateral ventricle is also larger, which is in part related to ex vacuo dilatation from white matter volume loss. However combination of these findings is suggestive of hemimegalencephaly.2. There has been progression of myelination since last study. Minimal areas of FLAIR hyperintensity persist in the subcortical white matter, including the left frontal and bilateral temporal lobes, which may be related to mildly delayed myelination given patient's age of 3.