Presentation
Long-standing seizures, epileptogenic lesion?
Patient Data
There is a focal juxta-cortical white matter T2/FLAIR hyperintensity in the left frontal lobe at the bottom of the inferior frontal sulcus with an associated thin linear increased T2/FLAIR signal extending from the apex of the lesion to the lateral ventricle ependymal surface (transmantle sign). Overlying cortex is thickened with a blurring of the grey-white interface. Small focus of white matter increased T2/FLAIR signal deep to the right cingulate gyrus region is nonspecific and of uncertain clinical relevance. The grey-white matter junction and appearance of the cortex is otherwise unremarkable, with no evidence of grey matter heterotopia. No intra or extra-axial mass or collection identified. The mesial temporal lobes, including the hippocampi, are unremarkable in size, signal and morphology.
Case Discussion
The imaging features favour left frontal lobe type II cortical dysplasia.
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