27 years, Female, Reason: structural lesion? History: seizure. Additional history per chart, patient has cerebral palsy and seizure disorder. There is diminished volume of supratentorial white matter in the bilateral parietal lobes with ex vacuo dilatation of the posterior aspects of the lateral ventricle and periventricular T2/FLAIR hyperintensity compatible with gliosis. There is associated thinning of the posterior aspect of the corpus callosum. Remainder of the brain parenchyma demonstrates no focal cortical dysplasia, gray matter heterotopia, or other lesions to suggest seizure focus. Bilateral hippocampi are symmetric in size, signal characteristics, and with preserved internal architecture. No restricted diffusion to suggest acute ischemia. No intracranial hemorrhage. No intracranial mass or mass-effect. No hydrocephalus. Paranasal sinuses and mastoid air cells are clear. Orbits and sella are grossly unremarkable. Calvarium and remainder of the extracranial soft tissues are also unremarkable.
1. Periventricular leukomalacia with significantly diminished bilateral parietal white matter volume likely reflecting remote, probable perinatal injury.2. No other focal structural lesions to suggest seizure focus.