Interactive Transcript
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This is a young child,
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approximately one year of age,
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who had enlarged ventricles and bilateral
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schizencephalic clefts.
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A shunt was placed, so you can see this
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ventriculostomy catheter that goes
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into this large CSF space.
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And we can see a large left-sided open lip
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schizencephalic cleft, or what looks like that.
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We can confirm that on MRI when we confirm that
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it's lined by gray matter.
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And also, a right-sided schizencephalic cleft.
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Once the shunt was placed,
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we can see the CSF space decreased in size.
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There's been decreased mass effect upon the
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remaining parenchyma of the left frontal
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lobe and the left occipital lobe.
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Here is the MRI appearance
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of the shunt apparatus.
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And notice that the right-sided schizencephalic cleft,
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you barely can see CSF going through it.
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So this now is closer to what people would refer to
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as a closed lip schizencephaly.
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You can see in this patient,
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there's abnormal sulcation lining the margins
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of the schizencephalic cleft.
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So, it's gray matter with polymicrogyria.
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If we go to the right side,
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we also see areas of polymicrogyria that shows
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up better on this axial T1-weighted image,
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where you have polymicrogyria lining this cleft.
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Now, this also brings about the challenges
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in pediatric imaging,
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where due to their small size
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and due to some movement,
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even sometimes if they're getting sedated,
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it can be difficult to get pristine images like
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you see in a textbook on every single case.
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But you don't need it.
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You don't need to prolong sedation in a child to
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get an image for a textbook
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as long as you can make a diagnosis.
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So if you know what you're looking for,
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if you make your diagnosis,
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all you need is images that can
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help you make your diagnosis.
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And so,
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this patient has bilateral schizencephaly,
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a large open-lipped left-sided
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schizencephalic cleft,
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and a very narrow open lip versus closed
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lip right-sided schismus. schizencephalic
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