Benign enlargement of the subarachnoid space in infancy

Case contributed by Eric F Greif
Diagnosis certain

Presentation

Macrocephaly.

Patient Data

Age: 9 months
Gender: Male

There is mild prominence of the bifrontal and right parietal/temporal extra-axial CSF spaces, measuring 0.8 cm in maximal depth, without evidence for effacement of the involved gyri. The cortical veins are adjacent to the inner table of the calvarium, best visualized on axial T2 images. No midline shift.

Axial T2 image demonstrates prominence of the bifrontal and right parietal/temporal extra-axial CSF spaces, without effacement of the involved gyri. Also of note, is that the cortical veins are adjacent to the inner table of the calvarium (yellow arrows). These finding are in keeping with benign enlargement of the subarachnoid space in infancy (BESSI).

Case Discussion

9 month old male with macrocephaly which prompted neuroimaging workup.  Patient is neurologically normal and had no history of trauma. Patients brain MR findings are consistent with benign enlargement of the subarachnoid space in infancy (BESSI)

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