Male 8 years old with left hemiparesis, focal onset epilepsy, right cortical dysplasia, evaluate changes in cortex Again seen is an abnormal gyral pattern in the right cerebral hemisphere involving the right posterior frontal, parietal, and temporal lobes with areas of cortical thickening consistent with polymicrogyria. Findings are most apparent in the right parietal lobe. Myelination is within normal limits. No focal parenchymal signal abnormalities are noted. No evidence of gray matter heterotopia. Bilateral hippocampi appear symmetric and normal in size.There is a minimal amount of rightward midline shift related to the right cerebral hemisphere being smaller than the left. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The pituitary gland appears grossly unremarkable. No hydrocephalus or extra-axial collections. The major cerebral flow voids are intact. The left middle ear cavity and mastoid air cells are opacified as before with improvement in the opacification of the paranasal sinuses.
1. Again seen is an abnormal gyral pattern in the right cerebral hemisphere involving the right posterior frontal, parietal, and temporal lobes with areas of cortical thickening consistent with polymicrogyria. Findings are most prominent in the right parietal lobe.2. No intracranial mass, infarct, or parenchymal signal abnormalities.3. Mild volume loss in the right cerebral hemisphere.