Male, 12 years old, with seizure and altered mental status in a child with sickle cell hemoglobinopathy, hypertension and vasculitis. Multiple scattered areas of subcortical T2 hyperintensity are redemonstrated without significant interval change. As before, these lesions are found in the bilateral frontal lobes, parietal lobes, occipital lobes, the temporal-occipital junctions, and the splenium of corpus callosum.Several of the above-mentioned lesions, including the most prominent lesion in the left parietal lobe, are associated with susceptibility effect. In addition, there are innumerable foci of susceptibility within the supratentorial brain with relative sparing of the posterior fossa. Most of these lesions, suspected to represent chronic microhemorrhage, show no correlating T2/FLAIR signal abnormality.No definite evidence of any new lesion is seen. No evidence of generalized mass effect is detected. The ventricular system is stable and normal in size.Diffuse marrow replacement and osseous expansion of the clivus are again seen likely related to sickle cell disease. The mastoid air cells are partially opacified.
1.No significant interval change in the size or number of numerous subcortical T2 hyperintense lesions.2.No significant interval change in the appearance of innumerable supratentorial chronic microhemorrhages.3.No new or progressing lesions are appreciated.