Bifrontal cystic encephalomalacia

Case contributed by Bahman Rasuli
Diagnosis almost certain

Presentation

Seizures and intellectual disability. History of neonatal hypoxic-ischemic brain injury after asphyxia.

Patient Data

Age: 13 years
Gender: Male

Bilateral symmetrical areas of cystic encephalomalacia in the frontal lobes. Bilateral symmetrical areas of watershed gliosis are also seen in both cerebral hemispheres, hyperintense on T2WI and FLAIR. No evidence of water restriction on DWI images. Frontoparietal cortical atrophy with ex-vacuo dilatation of the lateral ventricles, especially the frontal horns.

Mucosal thickening in the right maxillary sinus.

Case Discussion

This case illustrates brain damage caused by birth asphyxia.

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