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Post-traumatic encephalomalacia

Case contributed by Roberto Schubert
Diagnosis almost certain

Presentation

Incidental finding in an MRI prescribed for chronic headaches.

Patient Data

Age: 55 years
Gender: Male

Multiple regions of encephalomalacia and gliosis, most prominent in the temporal pole but also seen, less conspicuously, in the inferior surface of the frontal lobes. 

Case Discussion

This pattern of encephalomalacia / gliosis characteristic of a previous closed head injury, most likely representing a prior left occipital blow with contrecoup hemorrhaging contusions now resolved. 

As the history is often remote (many decades earlier) it is usually not deemed noteworthy, or even recalled. 

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