20-year-old male with history of pre-ALL which is in remission. Now with headache and possible seizure-like activity. Assess for structural masses or abnormalities. There are multiple foci of T2/FLAIR hyperintensity in the bilateral subcortical and periventricular white matter, which are nonspecific, but may represent treatment-related changes. Brain parenchyma is otherwise unremarkable for age. Hippocampus and visualized cortical structures demonstrate no focal lesions to suggest possible seizure focus. No abnormal parenchymal or meningeal enhancement. No restricted diffusion to suggest acute ischemia. No intracranial hemorrhage. No intracranial mass or mass-effect. The ventricles are within normal limits in size and configuration. Major flow-voids are preserved.T1 hyperintense focus involving the left parietal calvarium may represent focal fat or hemangioma. There is mild mucosal thickening involving the maxillary sinuses. Calvarium and extracranial soft tissues are otherwise unremarkable.
1. No evidence of intracranial mass or findings to suggest leukemic involvement in the brain.2. Several nonspecific foci of T2/FLAIR hyperintensity in the supratentorial white matter which are nonspecific but may represent sequela of prior treatment.