Microcephaly and lack of coordination. Additional history collected from electronic medical record: 4-year-old female born at 34 gestational weeks. Her foster mother brought her to pediatric neurology clinic with delayed speech, hypertonia-flexibility issues, developmental delays. Foster mom describes the patient as super forgetful. Had IEP which stated she functions at 30 months of age. It is believed that her birth mom was developmentally delayed and she did not receive any prenatal care. There is report of intrauterine growth retardation and question of intrauterine drug exposure. Her birth weight was 4 pounds 7 ounces. There is no developmental history of when Olivia walked or developed language. Foster mom states Olivia does have two siblings, one 8 year old and one 10 year old and they both also have some degree of microcephaly. There is a diffusely simplified gyral pattern of the cerebral hemispheres bilaterally and marked microcephaly. Otherwise, the degree of myelination is appropriate for age and the corpus callosum is fully formed. The cerebellar vermis may be mildly hypoplastic, but the cerebellar hemispheres and brainstem are intact. The pituitary gland is grossly unremarkable, with the posterior pituitary bright spot is demonstrated in normal location. There is no evidence of intracranial hemorrhage, mass, or infarction. The ventricles are not enlarged. There is no evidence of heterotopia or enlarged extra-axial cerebrospinal fluid spaces. There is no midline shift or mass effect. The cerebral flow voids appear to be intact. The orbits, paranasal sinuses, and mastoid air cells are grossly unremarkable.
Microcephaly with simplified gyral pattern.