Pre-and post enhanced brain MRI: Evaluate for seizure etiology. Signs and symptoms: GTC seizures. Pre-and post enhanced brain MRI:No acute intracranial process.There is a large focus of mildly hemorrhagic encephalomalacia involving the right posterior parietal and extending inferiorly into the right posterior temporal lobe, posterior aspect of the right insular cortex and right basal ganglia and right thalamus. The finding results in expansion of adjacent cortical sulci and right lateral ventricle. Finding is highly suggestive of a chronic right MCA hemorrhagic ischemic stroke. There is no evidence of enhancement at the site.Additionally there are small patchy foci of periventricular and subcortical flair/T2 hyperintensity in bilateral cerebral hemispheres without hemorrhagic changes or enhancement and highly suggestive of mild to moderate degree of chronic small vessel ischemic stroke.There is also suggestion of slight generalized prominence of cortical sulci for stated age which may represent mild underlying volume loss. Images through posterior fossa are unremarkable.Post enhanced images are negative or any detectable abnormal parenchymal, leptomeningeal, calvarial or retropatellar enhancement.Barium demonstrate a tiny bony defect in the right parietal representing a burr hole as was seen on head CT.
1.No acute intracranial findings.2.Large right hemispheric focus of mildly hemorrhagic encephalomalacia suggestive of a large chronic ischemic stroke as detailed above.3.Findings of mild to moderate chronic nonhemorrhagic small vessel ischemic strokes in the supratentorial parenchyma.4.No detectable abnormal enhancement.