Presentation
Seizures.
Patient Data
a subependymal mass is seen in the frontal horn of the left lateral ventricle near the foramen of monro that shows isosignal to grey matter on T1, hypersignal on T2 with vivid, homogeneous enhancement in keeping with subependymal giant cell astrocytoma
multiple calcified subependymal nodules of the wall of the lateral ventricles that show hypersignal on T1 with signal drop-out on GRE sequence
bilateral high T2 abnormal white matter linear signals are seen extending radially from the supratentorial cortex to the walls of the lateral ventricle (radial bands)
note is made of left maxillary sinusitis
a complementary CT was performed confirming the calcific nature of the subependymal nodules
no evidence of retinal phakomas
The annotated image illustrates the radial bands sign (red dotted line).
Case Discussion
MRI and CT findings are consistent with tuberous sclerosis.
The radial bands sign is thought to be relatively specific for tuberous sclerosis and should not be mistaken for the transmantle sign of type II focal cortical dysplasia.
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