Presentation
History of seizures, right hemiparesis, past history of some CNS infection in childhood (details not known).
Patient Data
Reduced volume of left cerebral hemisphere (hemiatrophy) with thickening of skull vault on left side, enlargement of left frontal sinus and falcine displacement towards left side.
Left lateral ventricle and convexity sulci on left side are dilated.
Atrophy with mild hyperintensity and loss of internal architecture of left hippocampus is seen with associated atrophy of left fornix, mammillary body and dilatation of temporal horn of left lateral ventricle – likely mesial temporal sclerosis.
Mild partial atrophy of left thalamus and cerebral peduncle seen – possibly Wallerian degeneration.
Cerebellum and pituitary gland are unremarkable.
Third and fourth ventricles are normal in size, shape and position.
Major signal void areas of brain are normal.
Case Discussion
Above findings are suggestive of Dyke-Davidoff-Masson syndrome with left mesial temporal sclerosis.