9-year-old male with headaches. Rule out multiple sclerosis. MRI BRAIN:Focus of T2/FLAIR hyperintense signal abnormality in the left centrum semiovale with mild asymmetric enlargement of the adjacent frontal horn of the left lateral ventricle probably representing ex vacuo dilatation, suggesting encephalomalacia in this area. These findings are not significantly changed from the previous exam.There is no evidence of acute intracranial hemorrhage, mass or edema. The ventricles and sulci are within normal limits. There is no midline shift or mass effect. The midline structures and craniocervical junction are within normal limits. The ventricles and basal cisterns are normal in size and configuration. No extra-axial fluid collection is identified.Minimal bilateral maxillary sinus mucosal thickening. The visualized mastoid air cells are clear. The orbits are unremarkable.MRA brain:Antegrade flow is present in the distal internal carotid arteries, the distal vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries.There is no evidence for intracranial aneurysm or cerebrovascular occlusion.The anterior communicating artery is identified. The posterior communicating arteries are not readily identified. The vertebral arteries are similar in size.
1.Stable small focus of encephalomalacia in the left centrum semiovale.2.No evidence for cerebrovascular occlusive disease or intracranial aneurysm.