Hemimegalencephaly

Case contributed by Hani Makky Al Salam
Diagnosis almost certain

Presentation

Left sided focal seizures.

Patient Data

Age: 12 days
Gender: Male
mri

The right cerebral hemisphere is enlarged consistent with hemimegalancephaly. The left side appears normal with no features suggesting volume loss - sulci are normal in size and white matter signal is normal. 

Case Discussion

It can be difficult distinguishing hemimegalencephaly from atrophy of the other side. Head circumference, CSF spaces and symptoms can be helpful. 

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