Multicystic encephalomalacia

Multicystic encephalomalacia corresponds to a variant of encephalomalacia commonly seen in neonates in which numerous loculated lacy pseudocysts within the white matter and cortex are present as a result of an extensive brain insult. 

It is a common feature observed in the neonatal hypoxic-ischaemic encephalopathy in a term neonate, including as a sequela of severe postnatal non-accidental head injury 3.

Multicystic encephalomalacia can be appreciated on both CT and MRI. Classic features generally include:

  • multiple cysts of varying size and shape located bilaterally within the cerebral white matter and inner layers of the cortex 4
  • relative sparing infratentorially, including of the cerebellum and spinal cord, except from Wallerian degeneration of the corticospinal tracts 3,4
  • relative sparing of some supratentorial structures including the basal ganglia, inferior temporal lobes, and orbital surfaces of the frontal lobes 3,4
  • ex vacuo dilatation of the lateral ventricles with intact ventricular walls 4

In cases secondary to severe postnatal non-accidental head injury, there may be evidence of chronic subdural haemorrhage, among other traumatic injuries.

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Article information

rID: 36635
Synonyms or Alternate Spellings:
  • Cystic encephalomalacia
  • Multi-cystic encephalomalacia

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