Reason: Patient with possible seizure please look for structural abnormality History: as above. There is confluent T1 hyperintensity involving the bilateral basal ganglia and thalami. There are multiple foci of susceptibility effect within the basal ganglia as well as the subcortical regions of the bilateral frontal lobes, which are abnormal and may represent mineralization or calcification. There is an additional focus of susceptibility in the left frontal corona radiata.No associated periventricular nodules or parenchymal signal abnormalities to suggest cortical tubers. No evidence of intracranial mass or mass effect. No findings to suggest cortical malformation, gray matter heterotopia, or other structural abnormalities to suggest seizure focus. Hippocampi appear symmetric and signal in size. The ventricles and sulci are normal in size. No diffusion-weighted abnormalities are identified. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. There is mild mucosal thickening of the left maxillary sinus.
Multiple foci of susceptibility effect in the subcortical white matter, particularly in the frontal lobes. Additional foci of susceptibility effect are seen in the left frontal corona radiata and basal ganglia. There is also abnormal T1 hyperintensity in the bilateral basal ganglia and thalami. The constellation of findings raises possibility of metabolic/endocrine disease with resulting mineralization/calcification producing the aforementioned susceptibility effect. CT can better confirm/assess extent of calcifications. Other differentials include prior infection or ischemic injury although no volume loss to support the latter. 