Evaluate for encephalopathy: meningitis, former 24 weeker. There is T1 hyperintensity in portions of the brainstem and bilateral posterior limbs of the internal capsules, but not in the rest of the cerebral hemisphere white matter. There are small foci of susceptibility effect in the left posterior fossa, without associated mass-effect. There is no evidence of acute infarct. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
1. Delayed myelination, even accounting for prematurity.2. No evidence of acute infarct. Non-contrast MRI is otherwise insensitive for the detection of meningitis.3. A small amount of chronic hemorrhage in the left posterior fossa without mass-effect is likely birth related.