 Previous foci of restricted diffusion involving the anterior body of the left corpus callosum, the anterior limb of the left internal capsule extending into the left corona radiata, and along the right and midline posterior body/splenium of the corpus callosum have resolved. There is no new restricted diffusion.Redemonstrated is prominence of the extra-axial spaces as seen on recent head CT, although better demonstrated by MRI to containtwo different processes within the extra-axial compartment. One of these would include CSF isointense prominence of the subarachnoid spaces, also extending along the anterior falx. Overlying this are more T1 hyperintense crescentic and nearly hemispheric collections (more T1 hyperintense on the right), which are both T2 hyperintense, representing slightly different aged subdural hemorrhages. The overall depth of both of these processes has not significantly changed (when compared to the more recent head CT and given differences in technique), and there is no significant underlying mass effect, although there is slight flattening of right parietal gyri.Redemonstrated are foci of punctate susceptibility along the right caudothalamic groove and lateral ventricular margin of the mid body of the right lateral ventricle. Additional punctate foci of susceptibility are seen dependently in the occipital horns bilaterally. These are stable in appearance.The right lateral ventricle remains slightly larger than the left. The basal cisterns remain patent. Overall, myelination pattern appears appropriate for the patient's corrected age, although as before the expected T2 hypointense findings in the posterior limb of the internal capsule and ventrolateral nucleus of the thalami appear slightly less distinct than as expected.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. There is persistent opacification of the left middle ear cavity and mastoid air cells.
1.Redemonstrated is prominence of the extra-axial spaces as seen on recent head CT, although better demonstrated by MRI to contain two different processes within the extra-axial compartment. One of these would include CSF isointense prominence of the subarachnoid spaces, also extending along the anterior falx, representing benign enlargement of the subarachnoid spaces which typically resolves by 2 years of age. Overlying this are more T1 hyperintense crescentic and nearly hemispheric collections representing slightly different aged subdural hemorrhages. The overall depth of both of these processes has not significantly changed, and there is no significant underlying mass effect, although there is slight flattening of right parietal gyri.2.Overall, myelination pattern appears appropriate for the patient's corrected age, although as before the expected T2 hypointense findings in the posterior limb of the internal capsule and ventrolateral nucleus of the thalami appear slightly less distinct than as expected.3.There is persistent opacification of the left middle ear cavity and mastoid air cells.