Global developmental delay with left hemiparesis, left ptosis, recurrent neck abscess, and tuft of hair on the sacral area. Brain: There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain, brainstem, cerebellum, and pituitary gland appear unremarkable. There is perhaps minimal prominence of the subarachnoid cerebrospinal fluid spaces overlying the bilateral frontal convexities. Otherwise, the ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable. There is nonspecific bilateral otomastoid fluid.Neck: There is a 5 mm diameter cystic focus in the right tracheoesophageal groove at the level of the thyroid gland. Otherwise, there is no evidence of abscess, mass lesions, or significant cervical lymphadenopathy. The major salivary glands are unremarkable. The major cervical flow voids are intact. Spine: There appears to be lumbarization of S1. The vertebral column alignment is within normal limits. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable. There is no significant spinal canal stenosis. The spinal cord displays normal signal and morphology. The conus medullaris terminates at the T12-L1 level. The paravertebral soft tissues are unremarkable.
1. No evidence of acute intracranial hemorrhage, mass, or acute infarct.2. Nonspecific 5 mm diameter cystic focus in the right tracheoesophageal groove at the level of the thyroid gland, for which the differential diagnosis includes a branchial apparatus anomaly or thyroid cyst, for example, but no evidence of residual retropharyngeal abscess. Ultrasound may be useful for further evaluation.3. Apparent lumbarization of S1 with conus medullaris at the T12-L1 level, but no evidence of fibrofatty filum or syringohydromyelia. 