Presentation
History of seizures under medication associated with mental impairment since birth.
Patient Data
Large, well-defined, extra-axial, wedge-shaped, cystic lesion of CSF density was noted in the left frontal region. The lesion is causing compression of:
the ipsilateral basal ganglia
frontal horns of the bilateral lateral ventricle
mild dilatation of occipital horn of right lateral ventricle
midline shifting of the ipsilateral lateral ventricle
However, no communication to the ventricular system is noted. There is no cortical scalloping seen with surrounding compressed brain parenchyma.
Case Discussion
Porencephaly presents as cystic changes in the cerebral parenchyma due to the destructive changes occurring after the migration of the neuronal tissues. Contrary to schizencephaly, which occurs before the migration, the cyst walls and clefts are not lined with grey matter.
These focal cavities are scarce in adults, frequently presenting in neonates and infants. Here, is a case of porencephaly in an adult female.
Although these lesions invariably communicate with the ventricular system, no such communication can be appreciated here.
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