Chronic bilateral occipital and parietal lobe encephalomalacia
Presentation
Visual impairment.
Patient Data
There are longstanding hypodensities in both occipital lobes and parietal lobes extending to the central sulci. Additional hypodensities are seen in the subcortical white matter of both frontal lobes. No acute infarct or intracranial hemorrhage.
An extracranial lipoma is also observed in the left occipital region.
Case Discussion
The distribution of infarcts in this patient is unusual and does not conform to a single vascular territory. The occipital lobes would be part of the posterior cerebral artery territory, with most of these territories spared. In contrast, the parietal lobes are at least partially within the middle cerebral artery territory. The frontal lobe changes are either middle cerebral artery or anterior cerebral artery territory.
Unfortunately, no clinical history is available to explain this distribution.
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