Schizencephaly
Findings:
Multiple MR images show a gray matter lined cleft extending from the sylvian fissure into the left lateral ventricle, associated with focal dilatation of the ventricle and dimpling of the ependymal surface.
Differential Diagnosis:
Open or closed lipped schizencephaly, remote insult with encephalomalacia (would not be grey matter lined)
Discussion:
nMigrational anomaly occurring at approximately 6 weeks gestation.
-other migrational anomalies may be associated: lissencephaly, polymicrogyria, pachygyria
-infarct vs. developmental, TORCH
->50% have septo-optic dysplasia
-less common with temporal or occipital clefts.
n -80% rule- bilateral, open, symmetric
nType I- closed lipped, near normal clinically vs. seizures and hemiparesis
nType II- open lipped, mental retardation/developmental delay, seizures, spasticity
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