Congenital oculomotor apraxia. The inferior cerebellar vermis appears to be slightly small and there is a mega cisterna magna. In addition, there appear to be punctate fluid signal intensity foci within the medial left cerebellar hemisphere, which may represent prominent perivascular spaces associated with a mildly anomalous foliation pattern. There is mild diffuse periventricular white matter T2 hyperintensity in the right peritrigonal region. The brain parenchyma otherwise appears unremarkable, with an expected degree of myelination. The corpus callosum is intact. There is asymmetry of the trigones of the lateral ventricles, in which the left is larger than the right. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is no evidence of hydrocephalus. There is no midline shift or herniation. The cisternal segments of the The pituitary appears unremarkable. The major cerebral flow voids are intact. There is fluid within the left mastoid air cells and and middle ear. The skull, paranasal sinuses, orbits, and scalp soft tissues otherwise appear unremarkable.
1. Suggestion of mild cerebellar development anomaly and asymmetry of the trigones of the lateral ventricles with signal abnormality in the right peritrigonal white matter may be related to congenital oculomotor apraxia.2. Nonspecific fluid in the left mastoid and middle ear may represent otomastoiditis.