Presentation
Long history of well-controlled epilepsy. Two recent seizures.
Patient Data
These select sequences demonstrate an atrophic right hemisphere, with prominently ex vacuo dilated right lateral ventricle and gliosis/periventricular FLAIR hyperintensity. In addition, there is compensatory bony changes, with a large right frontal sinus, as well as right sided calvarial thickening and elevated petrous ridge. The falx is also deviated to the right.
The remainder study (not shown) is unremarkable.
Case Discussion
This brain MRI demonstrates findings in keeping with Dyke-Davidoff-Mason syndrome: atrophy or hypoplasia of one cerebral hemisphere (hemiatrophy). In radiology, this so-called syndrome is more likely to represent a group of radiological findings that expresses a possible sequela of a fetal or early childhood period brain insult