Developmental delay, porencephaly, 4 month history of progressive hearing loss, gait decline, change in speech, and multifocal pains, intracranial bleeding, new-onset seizure like episodes and 50pound weight loss. Brain: There are bifrontal porencephalic cysts and deficiency of much of the septum pellucidum. There is layering intermediate T1 and low T2 signal hemorrhage in the occipital horns of the bilateral lateral ventricles. There is extensive supratentorial and infratentorial superificial siderosis. There are bilateral cerebral convexity subdural fluid collections, measuring 16 mm on the left and 6 mm on the right, with compression of the underlying brain. The ventricular system is unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. There is staphylomatous deformity of the right globe. There is a left maxillary retention cyst and mild right maxillary sinus mucosal thickening.Lumbar Spine: There is diffuse T2 hypointensity along the surface of the imaged spinal cord. There is also a small amount of high T1 and low T2 signal material within the inferior spinal canal. The vertebral column alignment is within normal limits. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable. There is no significant spinal canal stenosis. The paravertebral soft tissues are unremarkable.
1. Bifrontal porencephalic cysts.2. Layering subacute hemorrhage in the occipital horns of the bilateral lateral ventricles and subacute hemorrhage in the inferior spinal canal. 3. Bilateral cerebral convexity subdural effusions, left larger than right.4. Extensive superficial siderosis involving the intracranial contents and imaged potions of the spinal cord.