Glutaric aciduria type I

Case contributed by Mohammad A. ElBeialy
Diagnosis almost certain

Presentation

Delayed developmental milestones and mental retardation.

Patient Data

Age: 7 years
Gender: Male
mri
  • bilateral widened opercula and dilated sylvian fissures with "bat-wing" configuration
  • bilateral T2/FLAIR hyperintensity of the basal ganglia with diffusely increased T2 signal of the deep white matter and the globus palladius as well as the optic radiations with restricted diffusion
  • mild dilatation of the ventricular system
  • widened extra-axial CSF spaces
  • normal sellar region and posterior fossa

Case Discussion

Glutaric aciduria type I with atrophic brain changes.

Wide opercula and "cysts" in the Sylvian fissures as well as bright basal ganglia is virtually diagnostic of Glutaric aciduria type I.

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