mitochondrial disorder.

Small focal T2 hyperintensities are noted involving the posterior part of bilateral putamen with subtle patchy hyperintensities involving bilateral thalami associated with small patchy T2/FLAIR hyperintensities involving bilateral peritrigonal white matter as described – likely suggestive of mitochondrial disorder.

No evidence of acute infarct or restricted diffusion on DWI.

Recommend clinical correlation, MRS, follow up.