Female, 69 years old, with complaint of imbalance for three weeks. History of hypertension, CSF leak, seizure disorder. Presumed sequelae of sphenoethmoidal encephalocele repair are again seen. This includes encephalomalacia of the left gyrus rectus which has become more prominent when compared to the prior examination. While this examination is not tailored for a fine assessment of the skull base, no evidence of any significant or large encephalocele recurrence is seen.Scattered small foci of T2 hyperintensity are seen in the cerebral white matter and within the pons which also contains a more linear focal defect, all of which shows no significant interval change.Mild prominence of the CSF space along the anterior left temporal lobe is unchanged. No new or concerning extra-axial collections are seen. No evidence of significant intracranial hemorrhage is detected. The ventricular system is stable and normal in size.
1.Redemonstration of presumed sequelae of sphenoethmoidal encephalocele repair. Since the prior examination, encephalomalacia of the left gyrus rectus has become more prominent. Otherwise, no significant changes are seen.2.Scattered white matter and pontine lesions are redemonstrated, similar to the prior examination, likely representing chronic small vessel and lacunar ischemic disease.3.No new intracranial findings are seen which would account for the patient's symptoms.