Female, 3 years old, nonverbal with development delay and seizures, with a white matter lesion in the left frontal lobe on prior MRI. Please reevaluate. Again seen is ill-defined T2 hyperintense, T1 hypointense signal within the white matter along the lateral margin of the left frontal horn. Accounting for differences in technique, there has been no convincing interval change in the size or appearance of this abnormality. No definite abnormality of the overlying cortex is seen. On postcontrast images, there is no associated pathologic enhancement.Elsewhere, the appearance of the brain is unremarkable. No restricted diffusion is seen. No parenchymal edema or mass effect is detected. There is no evidence of intracranial hemorrhage or abnormal extra-axial fluid. No pathologic parenchymal or extra-axial enhancement is seen.Paranasal sinus mucosal inflammation evident on the prior examination has resolved.
Since the prior examination, there has been no significant or convincing interval change in the size or appearance of the ill-defined signal abnormality along the left frontal horn. No associated pathologic enhancement is seen. The differential diagnosis would continue to include chronic sequela of prior infection, inflammation or ischemia. The possibility of some form of focal cortical dysplasia is less likely given the normal appearance of the overlying cortex.