Tuberous sclerosis

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Seizures.

Patient Data

Age: 8 years
Gender: Male
mri
This study is a stack
Sagittal
T1
This study is a stack
Axial
FLAIR
This study is a stack
Axial
T2
This study is a stack
Coronal
T2
This study is a stack
Axial
Gradient Echo
This study is a stack
Axial
T1-IR
This study is a stack
Axial
T1 C+
This study is a stack
Axial
DWI
This study is a stack
Axial
ADC
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Info

The MRI sequences demonstrate:

  • multiple bilateral cortical and subcortical areas of low signal on T1, high signal on T2 and FLAIR with no enhancement on postcontrast sequences in keeping with cortical/subcortical tubers.

  • cluster of tiny cysts of CSF signal in the white matter arround the trigone and anterior horn of the lateral ventricles with surrounding abnormal high signal on FLAIR and T2, representing probably a cystic degeneration

  • numerous small subependymal nodules (hamartomas) along the wall of the lateral ventricles, iso-to high signal to the grey matter on T1, isosignal on T2 and FLAIR with moderate enhancement on postcontrast sequences. Some of them show a low signal on GE (calcified nodules)

  • Cavum septum pellucidum and vergae are noted (incidental findings)

Case Discussion

MRI feartures of tuberous sclerosis (known case on follow-up).

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