Diagnosis: Autistic disorderClinical question: Rule out seizure focusSigns and Symptoms: hx of autism spectrum disorder, behavioral issues The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a T2 and FLAIR hyperintense focus present along the posterior aspect of the right thalamus which measures approximately 3 mm in diameter. There is no associated susceptibility effect.A punctate FLAIR and T2 hyperintense focus is present along the right superior frontal gyrus subcortical white matter. Similar less conspicuous foci are present along the anterior aspects of the temporal lobes.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.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 demonstrate mucosal thickening throughout the paranasal sinuses as well as opacification of the frontal sinuses and left maxillary sinus.. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
A small 3mm lesion in the posterior aspect of the right thalamus and a small 3mm lesion along the right superior frontal gyrus subcortical white matter are nonspecific and of unknown clinical significance. These could simply represent enlarged perivascular spaces, however, the possibility that they are related to demyelination or prior injury cannot be excluded either.