Trisomy 21 and bilateral papilledema. Brain: There is no evidence of intracranial mass or acute infarct. There are punctate foci of susceptibility effect in the bilateral cerebellar hemispheres and right frontal lobe. The brain parenchyma and pituitary gland otherwise appear unremarkable. 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 skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable. However, the left lateral semicircular canal appears to be mildly bulbous.Orbits: There is no discernible prominence of the optic nerve discs. The globes, lacrimal glands, and extraocular muscles are intact. The optic nerves are unremarkable. There is no evidence of intraorbital mass lesions.
1. No evidence of hydrocephalus, intracranial mass, or acute infarct. 2. No discernible prominence of the optic nerve discs or intraorbital mass lesions. 3. Suggestion of mild left lateral semicircular canal dysplasia, which can be related to trisomy 21, although this exam is not optimized for the evaluation of the the temporal bones. Further evaluation via dedicated temporal bone imaging may be useful.4. Nonspecific punctate foci of susceptibility effect in the bilateral cerebellar hemispheres and right frontal lobe may represent sequela of prior hemorrhage, for example.