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MRI shows multiple areas of cortical/subcortical hyperintensities on T2-WI and FLAIR sequences compatible with tubers. There are multiple subependymal hamartomas and characteristic linear white matter bands (radial bands).
Tuberous sclerosis complex (Bourneville-Pringle disease) is a multisystem congenital syndrome. Tubers most commonly found in frontal lobes (90%). Cerebellar tubers are less commonly seen, where they may become apparent only at histologic examination. Magnetization transfer T1- weighted imaging can be superior to FLAIR imaging for detection of subtle tubers. Radial bands that believed to represent heterotopic glial and neurons along the expected path of cortical migration, are located in subcortical white matter and are thought to be specific for TSC.
Case courtesy of Prof. Ali Hekmatnia.