Perfusion abnormalities in hemimegalencephaly.
BACKGROUND
Cerebrovascular changes are rarely discussed in patients with hemimegalencephaly. These alterations have previously been associated with epileptical activity.


METHODS
We report the case of a 36-week gestation neonate presenting with total right hemimegalencephaly, as demonstrated by a magnetic resonance imaging (MRI) performed in the first days of life. Perfusion-weighted imaging displayed a clear hypervascularization of the right hemisphere. Diffusion-tensor imaging showed an arrangement of white matter fibers concentrically around the ventricle on the right hemisphere. AngioMRI showed an obvious asymmetry in the size of the middle cerebral arteries, with the right middle cerebral artery being prominent. The baby was free of clinical seizures during his first week of life. An electroencephalogram at that time displayed an asymmetric background activity, but no electrical seizures.


CONCLUSIONS
Perfusion anomalies in hemimegalencephaly may not necessarily be related to epileptical activity, but may be related to vessel alterations.
Wintermark
P
P
Division of Neonatology, Department of Pediatrics, University Hospital (CHUV) and Lausanne Medical School, Lausanne, Switzerland.
Roulet-Perez
E
E
Maeder-Ingvar
M
M
Moessinger
A C
AC
Gudinchet
F
F
Meuli
R
R
D002539:Cerebral Arterial Diseases / Q000175:diagnosis* / Q000209:etiology*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D004569:Electroencephalography / Q000379:methods; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007223:Infant; D018810:Magnetic Resonance Angiography / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D054220:Malformations of Cortical Development / Q000150:complications*