Male, 3 years old, status post traumatic brain injury resulting in left hemiparesis and gait disturbances. Evidence of prior left-sided craniotomy is again seen. No intracranial hemorrhage or any abnormal extra axial fluid collection is seen. Diffusion-weighted images are within normal limits.Areas of encephalomalacia are seen including along the left superior frontal sulcus, the left posterior medial temporal lobe, and the left medial occipital lobe, corresponding to areas which were diffusion restricting on prior studies. Patchy T2 hyperintensity is also seen within the periventricular white matter adjacent to the frontal horns and the left more than right periatrial regions. There may be mild curvilinear FLAIR hyperintensity within the left uncus but this could also be artifactual.No evidence of active parenchymal edema or mass effect is seen. Brain morphology and overall brain volume are within normal limits. Apart from ex vacuo dilatation of the left atrium, the ventricular system is within normal limits.
Findings are seen compatible with chronic parenchymal injury including areas of encephalomalacia within the left frontal lobe, the left posterior temporal and left occipital lobes. Scattered small foci of additional signal abnormality in the periventricular white matter may also represent sequelae of parenchymal injury. There is a questionable small area of abnormal signal within the left uncus.