Multicystic encephalomalacia

Case contributed by Dalia Ibrahim
Diagnosis almost certain

Presentation

Delayed mental and motor milestones. History of birth asphyxia.

Patient Data

Age: 1 year
Gender: Male
mri
This study is a stack
Sagittal
T2
This study is a stack
Axial
T2
This study is a stack
Axial
FLAIR
This study is a stack
Axial
Gradient Echo
This study is a stack
Axial
DWI
This study is a stack
Axial
T1
This study is a stack
Coronal
T1
This study is a stack
Axial
ADC
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Info

Both cerebral hemispheres parenchyma are replaced by multiple variable sized cystic areas of encephalomalacia involving the cortex and white matter.Ex vacuo dilatation of the lateral ventricles. Periventricular patches of gliosis eliciting high signal on T2 & FLAIR WI. Diffusely thinned corpus callosum. Preserved posterior fossa.

Opinion: Findings are impressive of multicystic encephalomalacia.

N.B: Enlarged nasopharyngeal adenoids.

Case Discussion

Multicystic encephalomalacia occurs in neonates after extensive brain insult resulting in loculated lacy pseudocysts within the white matter and cortex.

It is a common in neonatal hypoxic-ischaemic encephalopathy in a term neonate, including as a sequela of severe postnatal non-accidental head injury . 

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