Longitudinal CT and MR appearances of hemimegalencephaly in a patient with tuberous sclerosis

Childs Nerv Syst. 2008 Mar;24(3):397-401. doi: 10.1007/s00381-007-0463-x. Epub 2007 Sep 18.

Abstract

Case report: A 3-day-old baby was referred to our institution with seizures since birth and a presumptive diagnosis of cerebral tumor detected by prenatal ultrasound. Computed tomography (CT) and Magnetic Resonance (MR) imaging performed immediately after birth revealed the presence of an enhancing mass in the left cerebral hemisphere.

Discussion: The possibility of a congenital malignant brain tumor was considered. Although surgery was advised, the parents opted for conservative medical management. The infant was under treatment for seizures with antiepileptic drugs. At 7-month follow-up, there was a noticeable increase in the seizure activity with signs of developmental delay and increased head circumference. Repeat CT and MR imaging showed features of hemimegalencephaly with a calcified mass involving the left hemisphere. The patient was diagnosed to have tuberous sclerosis. This case report illustrates how an enhancing mass (possibly a tuber) over a period of time diminishes in size and becomes calcified in a patient with tuberous sclerosis and associated hemimegalencephaly.

Publication types

  • Case Reports

MeSH terms

  • Brain Neoplasms / complications
  • Brain Neoplasms / pathology*
  • Child, Preschool
  • Follow-Up Studies
  • Functional Laterality
  • Humans
  • Infant
  • Infant, Newborn
  • Magnetic Resonance Imaging
  • Male
  • Malformations of Cortical Development / complications
  • Malformations of Cortical Development / pathology*
  • Seizures / complications
  • Seizures / pathology*
  • Tomography, X-Ray Computed
  • Tuberous Sclerosis / complications*
  • Tuberous Sclerosis / pathology