 Brain: Evaluation of the myelination is limited due to motion. On the T1 weighted images, the myelination appears to be normal for corrected age. On the T2 weighted images, the myelination appears to be delayed, appearing similar to 9 and 11 months of age. Overall, there is decreased extent of hypointense signal in the central deep white matter as well as in expected subcortical areas at this age.There is focal prominent encephalomalacia in the left frontal lobe with ex vacuo dilatation of the lateral left lateral ventricle. The margins of the apparent encephalomalacic cleft demonstrate ill-defined T2/FLAIR hyperintensities representing gliosis. The lateral ependymal margin of the left lateral ventricle is entirely intact, and the apparent "cleft" is lined by areas of white matter.There is no pathologic midline shift. There is no abnormal enhancement. There is no evidence of acute hemorrhage or mass effect.There are no diffusion or susceptibility abnormalities.There is persistence of cavum septum pellucidum et vergae, normal variant.There is fluid in the bilateral mastoids and there is partial scattered opacification of the paranasal sinuses.MRI brain: The right A1 segment is hypoplastic. The bilateral PCOMs are not well-visualized. Otherwise, the internal carotid arteries, anterior, middle, and posterior cerebral arteries are patent. The vertebral and the basilar arteries are patent. No flow-limiting stenosis or aneurysm.MRA neck: The MRA of the neck is limited due to lack of contrast and motion. There is attenuation of flow related enhancement at the proximal petrous left ICA, likely artifactual due to tortuosity. The MRA of the neck is grossly unremarkable. The right internal carotid artery is smaller than the left, due to the hypoplastic right A1 segment.The left vertebral vertebral artery arise from the aortic arch, normal variant.
1. There is prominent left frontal encephalomalacia with ex vacuo dilatation of the adjacent left lateral ventricle.2. Normal myelination appearance on T1-weighted images, however delayed myelination pattern on T2-weighted images, similar to between 9 and 11 months of age.3. Unremarkable MRA head.4. Limited MRA of the neck due to lack of contrast and patient motion, but is grossly unremarkable.