Multicystic encephalomalacia - infant

Case contributed by Dr Ammar Haouimi

Presentation

Delayed milestones.

Patient Data

Age: 1 year
Gender: Female

The MRI sequences demonstrate:

  • decreased volume of both cerebral hemispheres
  • multiple cystic areas of various sizes and shapes within the cortex and white matter
  • ex vacuo dilatation of the lateral ventricles with intact ventricular walls
  • atrophy of the corpus callosum
  • occipital cortical laminar necrosis of high signal on T1
  • preserved posterior fossa
  • relative sparing of some supratentorial structures (basal ganglia, inferior temporal lobes, occipital lobes, and orbital surfaces

Case Discussion

MRI features of a multicystic encephalomalacia which is the result of an extensive brain insult in term neonate from ischemia, infection or developmental insults in the antenatal or early postnatal period.

The multiple cysts result from the destruction of the cerebral white matter and the linear septae represent glial cells with some viable neurons.

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