Presentation
Seizures, prior history of high grade fever in childhood.
Patient Data
Left cerebral hemiatrophy is seen with volume loss and gliotic areas in frontoparietal lobes, likely sequel of prior encephalitis. Ex-vacuo dilatation of left lateral ventricle is seen.
Associated compensatory thickening of bony calvarium is seen on left side.
Partial atrophy of left cerebral peduncle is seen, likely Wallerian degeneration.
Atrophy of right cerebellar hemisphere and middle cerebellar peduncle is seen with hyperintensity / gliosis and prominence of cerebellar folia, fourth ventricle.
Partial atrophy with mild hyperintensity and loss of internal architecture of left hippocampus is seen with ex-vacuo prominence of temporal horn of left lateral ventricle, possibly mesial temporal sclerosis or sequel of prior encephalitis.
Focal T2/T2 FLAIR hyperintensity is seen in subcortical white matter of right frontal lobe, possibly nonspecific white matter hyperintensity / chronic lacunar infarct.
Case Discussion
Overall findings are suggestive of crossed cerebellar diaschisis. Right cerebellar trophy with gliosis is seen which is likely secondary to gliosis/insult in left cerebral hemisphere.
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