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.
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Pathology
It is a common feature observed in neonatal hypoxic-ischemic encephalopathy in a term neonate, including as a sequela of severe postnatal non-accidental head injury 3.
Radiographic features
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 hemorrhage, among other traumatic injuries.
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