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Multicystic encephalomalacia

Case contributed by Heba Abdelmonem
Diagnosis almost certain

Presentation

Delayed motor and mental milestones, with generalized hypotonia since birth. The mother gave history of full-term vaginal delivery. No history of head trauma or child abuse was recorded. No history of previous CT of the brain. No history of seizures.

Patient Data

Age: 2 years
Gender: Male

Multicystic encephalomalacia is diffuse involvement of the cerebral white by hypodense cystic areas resembling lace associated with dilatation of the supratentorial ventricular system. Preserved posterior fossa with normal CT appearance.

Case Discussion

Multicystic encephalomalacia is a sequela of diffuse hypoxic-ischemic insult of the brain, it is commonly characterized by atrophic expansion of the ventricles with intact ventricular walls, multiple cysts of different sizes involving the cerebral white matter, the cerebellar hemispheres, and the spinal cord is usually spared apart from Wallerian degeneration of the corticospinal tracts.

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