Hypoxic Destructive Lesions

Porencephaly: cyst in the brain that communicates with the ventricle or the subarachnoid space.

Probably due to neonatal infarct, trauma, or infection.

DDx: Porencephalic cysts are lined by gliotic white matter whereas schizencephaly is lined by grey matter.

Dyke Davidoff syndrome possible (hemiatrophy of the brain with compensatory thickening of the skull and enlargement of the paranasal sinuses ipsilaterally).

Hydranencephaly: reabsorption/destruction of the cerebral hemispheres thought to be due to bilateral ICA occlusions although congenital infection may also be a cause.

There is a preservation of the more primitive areas (thalami, brain stem, and the falx is also preserved).

Differential diagnosis of water filled brain should include hydranencephaly, marked hydrocephalus (still has a mantle of brain beyond the dilated ventricles), and alobar holoprosencephaly (no falx).

{To return to cases, use the "Back " button on the Toolbar}