Anoxic hypoxic encephalopathy (MR).

Look here to the basal ganglia you can find two symmetrical faintly hyper intense areas on this T2 image.

The following 4 images are Diffusion sequence revealing hyper intensity in cortico-spinal tract along the anterior surface of mid  brain

Here are reaching to both basal ganglia.

Then peri ventricular regions bilaterally.

Finally in both centrum semi ovale regions.

PROTOCOL:

T1W – Sagittal & axial scans
T2W – Axial & coronal scans
FLAIR – Axial scans

FINDINGS:

-Evidence of bilateral symmetrical foci of hyper intensity is noted in both basal ganglia and extending to peri ventricular and centrum semi ovale regions in addition to spino-cortico tract in the brain stem. These changes are fairly seen on T2 and Flair images.
-Evidence of increased peri optic CSF space fluid with flattening of posterior sclera (right optic meningeal sac measuring 9 mm while the left one is measuring 10 mm on coronal T2 view).
-Bilateral symmetrical foci of blooming effect are noted in the genu of both internal capsules on Gradient frequency while on T1 and T2 they give hypo intensity giving impression of acute blood (giving hypo intensity on T1 and T2) or calcium.

-the rest of the brain Parenchyma shows normal grey white matter differentiation and signal intensities.  No focal mass lesion is seen.
-Lateral and third ventricles are normal in size and position. Septum is in midline.  There is no midline shift.
-Basal cisterns, cortical sulci and gyri are normal in appearance.
-Corpus callosum shows normal MR morphology.
-Brain stem and cerebellum show normal signal intensities.
-Fourth ventricle is normal in size and is midline in position.


OPINION:

-Revealed:
• Anoxic hypoxic encephalopathy (mild degree).
• Probability of increased intra cranial tension for further evaluation.
• Possibility of bilateral acute hemorrhagic spots in both internal capsules for clinical correlation.