13-month-old male with DiGeorge syndrome and traumatic brain injury. Per the electronic medical record, the patient was born prematurely and subject to abuse with prior subdural hematoma. There are subdural hematomas along the bilateral cerebral convexities without significant mass effect. The collections are predominantly T1 isointense and T2 hyperintense with the right slightly larger than the left. The right subdural collection also contains a small amount of T1 hyperintense signal, which suggests a recent component. There is marked cystic encephalomalacia in the parietal, occipital, and temporal lobes bilaterally. Milder encephalomalacia changes are present in the right superior frontal lobe. There is severely diminished supratentorial white matter. The lateral and third ventricles are markedly enlarged. No restricted diffusion to suggest acute ischemia. No intracranial mass or mass-effect. Major flow-voids are preserved.Bilateral cleft lip with a cleft defect in the maxilla is noted. However, the maxillofacial structures are incompletely evaluated.
1. Extensive cystic encephalomalacia involving the bilateral cerebral hemispheres which may be related to prior diffuse anoxic brain injury. 2. Marked dilatation of the lateral and third ventricles, likely primarily due to ex vacuo dilatation. However, a component of hydrocephalus cannot be completely excluded. Comparison with prior examinations would be beneficial if available.3. Bilateral, right greater than left, cerebral convexity subdural hematomas with a small areas of T1 hyperintensity indicating a subacute component. No significant associated mass effect.