Multicystic encephalomalacia

Case contributed by Dr Arthur Daire

Presentation

History of severe birth asphyxia. Diagnosed with "hydrocephalus" and a VP shunt was placed. Presented now with depression of skull and weakness. Suspected shunting.

Patient Data

Age: 1 year 1 month
Gender: Female
MRI

Bilateral severe cystic encephalomalacia.

VP shunt noted in the left parietal region, with tip in one of the cystic components, and not in the lateral ventricle (seen better on the coronal T2 images)

Case Discussion

This case demonstrates severe cystic encephalomalacia, likely following birth asphyxia. It seems this child was misdiagnosed as hydrocephalus on ultrasound and a VP shunt inserted into one of the cystic components.

Cystic encephalomalacia has also been described as a consequence of child abuse 1

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