info@biomedres.us   +1 (502) 904-2126   One Westbrook Corporate Center, Suite 300, Westchester, IL 60154, USA   Site Map
ISSN: 2574 -1241

Impact Factor : 0.548

  Submit Manuscript

Case ReportOpen Access

Cystic Encephalomlacia-Mr Imaging Volume 12 - Issue 4

Lokesh Rana1*, Dinesh Sood1, Pooja Gurnal2 and Manjuswamy2

  • 1Department of Radio diagnosis, India
  • 2Department of Anaesthesia, India

Received: December 17, 2018;   Published: January 02, 2019

*Corresponding author: Lokesh Rana, Department of Radio diagnosis, India

DOI: 10.26717/BJSTR.2019.12.002277

Abstract PDF

Abstract

Encephalomalacia is sequelae to injury to the brain which can be haemmorage, ischemia, traumatic, infective etc. or end results of liquefactive necrosis of the brain causing its softening, cystic degeneration and surrounding gliosis [1,2]. We are presenting a case of cystic encephalomalacia in young adult with probable vascular insult in left MCA territory [1-3].

Case Report

We present a case of 32-year male presenting with right sided hemi pareses, focal seizure and headache. MRI imaging showed a well-defined multilobulated lesion seen left cerebral hemisphere and shows CSF signals on all pulse sequences without diffusion restriction or post contrast enhancement. There is presence of ex vacuo dilation of ipsilateral left lateral ventricle. Diagnosis of cystic encephalomalacia secondary to vascular insult in the remote past was made.

Discussion

Encephalomalacia is sequelae to injury to the brain which can be haemmorage, ischaemia, traumatic, infective etc. or end results of liquefactive necrosis of the brain causing its softening, cystic degeneration and surrounding gliosis [4,5].

Clinical Manifestations: Can be seen in any age group or sex, asymptomatic if focal or may present with focus of seizure, hemiparesis or paresthesias and headache [1].

Key Imaging Diagnostic Clues:

a) CT shows hypo attenuating areas with cystic changes with ex-vacuo dilation of ipsilateral ventricles [1,6].

b) MRI shows CSF signals on all pulse sequences with gliosis better appreciated on FLAIR sequence [5,6].

Conclusion

Cystic encephalomalacia have characteristic Computed Tomographic features of hypo attenuating areas with cystic changes with ex-vacuo dilation of ipsilateral ventricles. MRI shows CSF signals on all pulse sequences with gliosis better appreciated on FLAIR sequence.

References

  1. Osborn AG, Salzman KL, Jhaveri MD, Barkovich AJ (2015) Diagnostic imaging: brain E-book. Elsevier Health Sciences, pp. 1200.
  2. Bugnone AN, Hartker F, Shapiro M, Pineless HS, Velez G, et al. (2006) Acute and chronic brain infarcts on MR imaging in a 20-year-old woman with acute posterior multifocal placoid pigment epitheliopathy. AJNR Am J Neuroradiol 27(1): 67-69.
  3. Barkovich AJ, Hallam D (1997) Neuroimaging in perinatal hypoxic-ischemic injury. MRDD Research Reviews 3(1): 28-41.
  4. Johnston MV, Hoon AH (2000) Possible mechanisms in infants for selective basal ganglia damage from asphyxia, kernicterus, or mitochondrial encephalopathies. J Child Neurol 15(9): 588-591.
  5. Rowland EH, Poskitt K, Rodriguez E, Lipton BA, Hill A, et al. (1988) Perinatal hypoxic-ischemic thalamic injury: clinical features and neuroimaging. Ann Neurol 44(2): 161-166.
  6. Barkovich AJ, Westmark K, Partridge C, Sola A, Ferriero DM, et al. (1995) Perinatal asphyxia: MR findings in the first 10 days. Am J Neuroradiol 16(3): 427-438.