Female, 5 months old, with new diagnosis of infantile spasms. Evaluate for signs of tuberous sclerosis or other intracranial abnormalities. Gyral simplification and marked cortical thickening is seen bilaterally and symmetrically involving the posterior frontal and parietal lobes, particularly in the perisylvian regions. The anterior frontal lobes and the occipital and temporal lobes are affected to a much lesser degree if at all.As result, the brain demonstrates a slightly dysmorphic configuration. The pituitary region is unremarkable. The corpus callosum appears to be fully formed and intact. The cerebellum likewise appears to be normally formed. The tectum may be slightly thicker than what is typically seen, but the brainstem is otherwise unremarkable.The pattern of white matter myelination is otherwise appropriate for age. The ventricles are mildly dysmorphic and prominent but this is likely secondary to the parenchymal abnormalities. No evidence of any intracranial hemorrhage or abnormal extra-axial fluid collection is seen.
Pachygyria is seen affecting the posterior frontal and parietal lobes bilaterally and symmetrically. Apart from this, no other focal or acute abnormalities are identified.