 There is no evidence of intracranial hemorrhage. There has been an interval increase in size of the confluent patchy regions of T2 hyperintensity and T1 hypointensity throughout the supratentorial white matter. In addition, there are more prominent and confluent regions of decreased diffusion throughout the supratentorial cortex as well as the basal ganglia and thalami. The ventricles and sulci have slightly increased in prominence, likely due to global volume loss. There is no midline shift or herniation. The major cerebral flow voids are intact. The skull, paranasal sinuses, and scalp soft tissues are unremarkable. There is fluid within the bilateral mastoid air cells.
Finding most compatible with severe hypoxic ischemic injury with interval evolution since the prior exam.