14-year-old male with familial hemophagocytic lymphohistiocytosis and cerebral palsy with epilepsy now experiencing increased somnolence with EEG changes. There is extensive diffuse cerebral, brainstem, and cerebellum volume loss with white matter T2 hyperintensity, representing gliosis, is not significantly changed. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is no abnormal intracranial enhancement. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, and scalp soft tissues are grossly unremarkable. There is a small right maxillary sinus retention cyst.
No significant interval change of both supratentorial and infratentorial abnormalities without enhancement.