MRI-Brain/Stem (W/O Contract)

*Final Report*

Date of Test: 02/09/2006

Exam: MRI OF THE BRAIN WITHOUT CONTRAST

History: A 6 month old male born at 40 weeks gestation with new onset of seizures x2 to 3 weeks

Technique:
1. No comparison
2. MRI of the brain was preformed without contrast with multiplanar, multi sequential imaging
3. Sedation utilizing chloral hydrate per the Sedation Team

Findings: This study is limited secondary to motion artifact. As visualized, there is cortical thickening involving the posterior aspects of the bilateral frontal and temporal lobes and the anterior occipital lobe and the bilateral parietal lobes, predominantly with a perisylvian distribution. There is fine cortical undulation. There is sparing of the anterior aspects of the frontal and temporal lobes. These findings are compatible with cortical dysplasia, specifically polymicrogyria. There is a moderate degree of ventriculomegaly involving the third and lateral ventricles, being less prominent within the bilateral occipital horn which may be secondary to the cortical dysplasia versus less likely hydrocephalus. The cerebellar tonsils are in normal position with normal signal. There is no acute hemorrhage, midline shift, or abnormal extra axial fluid collections. The basal cisterns appear within normal limits. There is no evidence of acute ischemia on diffusion imaging. There are normal flow voids within the anterior and posterior circulations.

Impression:
1. Study limited secondary to motion artifact.
2. Findings compatible with a polymicrogyria, cortical dysplasia in a predominately perisylvian distribution as described above.
3. Moderate degree of ventriculoegaly involving the third and lateral ventricles which is likely secondary to the cortical dysplasia with less likely consideration including hydrocephalus.