Infant born at 37 1/7 weeks with respiratory distress. Please evaluate corpus callosum: possible agenesis of corpus callosum on ultrasound. Dysmorphic features (redundant skin folds, edema, micrognathia with recessed jaw). There are several subcentimeter foci of restricted diffusion in the left frontal lobe periventricular white matter. There is a lesion in the left caudothalamic groove with cerebrospinal fluid signal characteristics that measures up to 5 mm. There is diffuse paucity of cerebral white matter with apparent deficiency of myelination in the bilateral corticospinal tracks. There is no evidence of intracranial hemorrhage or mass. There is no midline shift or herniation. The major cerebral flow voids are grossly intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
Subcentimeter acute infarcts in the left frontal lobe periventricular white matter, persistent ventriculomegaly that appears to be associated with diffuse cerebral white matter deficiency with severe thinning of the corpus callosum diffusely, as well as apparent delayed myelination, a subcentimeter lesion in the left caudothalamic groove, which may represent a germinolytic cyst, and cerebellar vermis hypoplasia may represent stigmata of an underlying disorder of metabolism or other congenital anomaly. Follow up with MR spectroscopy of the brain may provide additional insights.Discussed with Dr. Singh at 12 PM on 9/23/15.