Reason: h/o Lhermitte duclos and cerebellar lesion - pls do T2/FLAIR History: preop planning for craniotomy - pls do T2/FLAIR The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a tiger stripe non-enhancing appearance of the left cerebellar hemisphere and vermis with distortion of the morphology of these structures. The cerebellar tonsils extend through the foramen magnum by approximately 10 mm.There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images. Findings suggest a burr hole in the right frontal bone as well as prior ventriculostomy tract along the right frontal lobe.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.Findings are suspicious for Lhermitte Duclos (dysplastic gangliocytoma) involvement of the left cerebellar hemisphere and vermis. There is associated Chiari one malformation. The lateral ventricles are not enlarged at this time.2.Periventricular and subcortical white matter signal changes of a mild degree (several lesions) are present which are nonspecific. They are likely of little clinical significance. 