History of severe birth asphyxia. Diagnosed with "hydrocephalus" and a VP shunt was placed. Presented now with depression of skull and weakness. Suspected shunting.
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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)
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.
- 1. Matlung SE, Bilo RA, Kubat B et-al. Multicystic encephalomalacia as an end-stage finding in abusive head trauma. Forensic Sci Med Pathol. 2011;7 (4): 355-63. doi:10.1007/s12024-011-9236-7 - Free text at pubmed - Pubmed citation
- 2. Naidich TP, Chakera TM. Multicystic encephalomalacia: CT appearance and pathological correlation. J Comput Assist Tomogr. 1984;8 (4): 631-6. Pubmed citation
- 3. Frigieri G, Guidi B, Zaccarelli S et-al. Multicystic encephalomalacia in term infants. Child's Nerv Syst. 1996;12 (12): 759-764. doi:10.1007/BF00261594