Male 14 months old Reason: IVH, born 25 wk gestation, one of triplets. There is a large oval CSF signal intensity structure centered in the right parietal region representing a porencephalic cyst which communicates with the body of the right lateral ventricle. There is associated loss of parenchymal tissue involving a majority of the right parietal lobe, a portion of the posterior right frontal lobe, as well as the right corpus callosum, distal to the anterior body. This cyst measures 5.7 cm in craniocaudal dimension and 5.9 x 2.7 cm in axial dimensions, and results in mild localized mass effect. There are more focal areas of encephalomalacia along the posterior aspect of the cyst as well as susceptibility artifact consistent with hemosiderin staining suggesting prior hemorrhage.There is mild-moderate dilatation of the lateral and third ventricles, as well as anterior subarachnoid spaces. Susceptibility in the occipital horns in noted, consistent with history of intraventricular blood products. The distal right anterior cerebral artery flow void is absent. Otherwise the major cerebral flow voids are intact.With regard to corrected age, the visualized white matter appears somewhat delayed in myelination pattern on T2 imaging. However on T1 imaging the white matter appears more compatible with expected appearance although the arborization is somewhat decreased, likely secondary to diffuse paucity of white matter. The cerebellum is somewhat dysplastic with crossing folia suggesting some degree of rhomboencephalosynapsis. There is also hypoplasia of the inferior aspect of the cerebellum. There are a few scattered punctate foci of susceptibility in the cerebellum suggesting possible prior punctate hemorrhage.
1.Large right porencephalic cyst with associated parenchymal loss of white matter and cortex of the majority of the right parietal lobe and a portion of the posterior right frontal lobe as detailed above. Evidence of hemosiderin deposition along the severely encephalomalacic right posterior parietal region indicating previous hemorrhage. Mild localized mass effect.2.Dysplastic cerebellum with suggestion of rhomboencephalosynapsis.3.Heart absence of the posterior right corpus callosum.4.Mildly delayed myelination pattern on T2-weighted images with overall significant possibly of white matter volume.5.Prominence of ventricles and anterior subarachnoid spaces which may in part relate to the generalized volume loss as well as superimposed benign enlargement of subarachnoid spaces of infancy which should resolve by 2 years of age.6.Trace hemosiderin in the occipital horns dependently, relating to previous intraventricular blood products.