No abnormal extracerebral collections are present.
The orbital contents are without abnormality.
Bilateral mastoid effusions.
1. Symmetric diffusion restriction within the brainstem and deep gray nuclei with associated T2/FLAIR signal abnormality, increased cerebral blood flow, and patchy parenchymal enhancement. These findings are in keeping with reported history of Leigh's disease and are new compared to the prior exam from August 9, 2016.
2. Small region of restricted diffusion in the high paramedian left parietal lobe concerning for a small acute infarct.