Developmental delay and Sandifer's syndrome. Evaluate for sequela of HIE versus dysplastic brain. There is no significant interval change in the dysplastic appearance of the brain. Again seen is asymmetric dilatation of the right lateral ventricle. The left putamen appears enlarged and abnormally shapred, and the lentiform nuclei on the left collectively seem to wrap around the left frontal horn suggesting dysplasia. There are several foci of T2 hyperintensity in the periventricular white matter of the bilateral cerebral hemispheres are well as subcortical white matter of the bilateral anterior frontal lobes, left greater than right. The gyration pattern of the cerebral hemisphere is otherwise grossly unremarkable. The myelination pattern is appropriate for age. The brainstem is hypoplastic and most pronounced in the pons. In addition, the right half of the brainstem appears to be slightly larger than the left side. There is a left choroidal fissure cyst.The cerebellum also appears to be dysplastic, in which the right hemisphere is larger than the left and associated anomalous foliation pattern. The inferior cerebellar vermis lobules also appear somewhat underdeveloped. The fourth ventricle appears enlarged. The corpus callosum is fully formed, but appears to be slightly smaller than normal. There is no evidence of acute intracranial hemorrhage, mass, or acute infarct. The major cerebral flow voids appear to be grossly intact. There is no midline shift or herniation. The skull and extracranial soft tissues are unremarkable.
No significant interval change in the appearance of abnormal brain morphology, which is likely at least partly congenital and related to dysplasia or maldevelopment. 