Focal cortical dysplasia - type II

Case contributed by Craig Hacking
Diagnosis certain

Presentation

Intractable seizures

Patient Data

Age: 65 years
Gender: Female
This study is a stack
Sagittal
FLAIR
This study is a stack
Axial
T2
This study is a stack
Axial
FLAIR
This study is a stack
Axial
T1
This study is a stack
Axial
DWI
This study is a stack
Axial
ADC
This study is a stack
Axial
SWI
This study is a stack
Coronal
T1
This study is a stack
Coronal
T2
This study is a stack
Coronal
FLAIR
This study is a stack
Coronal FLAIR Mesial
temporal lobes
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Info

There are two triangular foci increased T2/FLAIR cortical signal in the left posterior frontal lobe involving the precentral gyrus. On the coronal sequences, the apex of the lesion points towards the ventricle with thin linear increased T2/FLAIR extending to the ependymal surface of the left lateral ventricle. This represents the transmantle sign of Blumcke type II focal cortical dysplasia.

There is subsequent loss of normal volume, increased T2/FLAIR signal and loss of normal internal architecture within the left hippocampus in keeping with secondary mesial temporal sclerosis. No forniceal atrophy.

Case Discussion

Great example of focal cortical dysplasia (two lesions) causing mesial temporal sclerosis.

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