Female, 6 years old, with history of neonatal hypoxic ischemic encephalopathy from fetal maternal hemorrhage with bilateral infarcts, history of neonatal seizures, now with recurrence of generalized tonic clonic seizures. Large areas of encephalomalacia are seen involving the bilateral parietal lobes and to a lesser degree the bilateral frontal lobes. The residual gyri in these areas are shriveled and dysmorphic. Abnormal T2 signal is evident within the adjacent white matter at these locations.No evidence to suggest active parenchymal edema or mass effect is seen. No restricted diffusion is identified. There are no abnormal extra-axial collections and no evidence to suggest acute intracranial hemorrhage. Ex vacuo dilatation of the ventricular atria, left side more than right is seen. Otherwise, the ventricular system is within normal limits.
Fairly extensive and bilaterally symmetric encephalomalacia of the parietal and to a lesser degree frontal lobes compatible with chronic sequelae of hypoxic ischemic injury.No evidence of active parenchymal edema, intracranial hemorrhage or any other acute finding.