 There is persistent T2 hyperintensity within the white matter, specifically involving periatrial terminal myelination zones (which normally should have resolved by 12 years of age), however there are also more punctate foci within both periventricular and subcortical bifrontal white matter. There is no associated restricted diffusion, enhancement, or susceptibility abnormality. The ventricles and sulci are normal in size. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. The pituitary gland is normal in size. There is no evidence for intracranial hemorrhage or acute cerebral, brainstem or cerebellar infarction. No diffusion-weighted abnormalities are identified. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. The paranasal sinuses and mastoid air cells are clear. There is no abnormal enhancement within the brain. Incidental note is made of tiny postinflammatory cysts in the nasopharynx.A review of the temporal bone CT favors a uniform facial nerve appearance bilaterally with an adjacent stapedius muscle.Images of the internal auditory canals demonstrate the seventh and eighth nerves to be normal in size and symmetric bilaterally without masses or enhancing lesions along the course of these nerves or in the cerebellopontine angle cisterns bilaterally. The inner ear structures are normal in appearance and symmetric bilaterally without congenital inner ear anomalies identified on either side. There are no vascular anomalies.
1.There is persistent T2 hyperintensity within the white matter, specifically involving periatrial terminal myelination zones (which normally should have resolved by 12 years of age), however there are also more punctate foci within both periventricular and subcortical bifrontal white matter. There is no associated restricted diffusion, enhancement, or susceptibility abnormality. This constellation of features is most consistent with a prior gliotic inducing process such as periventricular leukomalacia.2.MRI demonstrates intact bilateral seventh and eighth nerve complexes.3.The course of the facial nerve is better demonstrated by previous CT which demonstrates a uniform facial appearance bilaterally with an adjacent stapedius muscle.