Case contributed by Ashish Mohan Bhattarai
Diagnosis almost certain


History of seizures under medication associated with mental impairment since birth.

Patient Data

Age: 65 years
Gender: Female

Large, well-defined, extra-axial, wedge-shaped, cystic lesion of CSF density noted in the left frontal region. The lesion is causing compression of:

  • the ipsilateral basal ganglia,
  • frontal horns of 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.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.