Female, 10 years old, with tract seizures, history of Alpers syndrome. Gyriform T2 hyperintensity seen on the prior examination within the right parietal and occipital lobes is no longer clearly identified. Subtle diffuse T2 hyperintensity of the caudate and putamina bilaterally is unchanged. T2 hyperintensity of the posterior thalami is unchanged on the right, but progressed on the left. Cavitation of the medullary olives is unchanged.No evidence of significant parenchymal mass effect is seen. No restricted diffusion is detected. A right frontal lobe developmental venous anomaly is again seen. No evidence of significant intracranial hemorrhage or any abnormal extra axial fluid collection is detected. The ventricles are normal in size and shape.
Since the prior examination, some fluctuation in areas of parenchymal signal abnormality is detected. For example, regions of gyriform signal abnormality seen previously within the right parietal and occipital lobes seem to have resolved. However, signal abnormality within the left thalamus has progressed.Diffuse signal abnormal involving the basal ganglia, and cavitation of the medullary olives, are stable findings. No entirely new intracranial lesions are detected.