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ULTRASOUND IN
SCHIZENCEPHALY (1,2) |
- Symmetrical clefts in the area of the lateral sulcus (of Sylvius).
- Unilateral or bilateral.
- Location.
- most commonly near the pre- and post central gyri.
- Ventricles are dilated and communicate freely with the clefts (Type II cleft) or are normal ventricle (type I cleft).
- In Type I clefts the walls oppose one another obliterating the CSF space and may be missed if the imaging plane is parallel to the cleft.
- Midline structures are normal.
- Head size - normal or microcephalic.
- Color Doppler The middle cerebral arteries are either:
- Normal but displaced by the cleft.
- Occluded (1).
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MRI FINDINGS (3) |
- Full thickness cleft through the hemisphere.
- Grey matter lining the cleft and extending through the hemisphere. (Pathognomonic).
- Wide separation of the lateral ventricles and squaring of the frontal lobes.
- Absent cavum septi pellucidi (80-90%).
- Absent corpus callosum.
Type I – Closed lip schizencephaly |
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Type II – Open lip schizencephaly |
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DIFFERENTIAL DIAGNOSIS |
- Porencephaly (local parenchymal destruction due to vascular, infectious or traumatic insults). This is almost always unilateral.
- Arachnoid Cyst.
- Cystic tumor.
REFERENCES |
- Suchet IB. Schizencephaly: antenatal and postnatal assessment with color-flow doppler imaging. Can Assoc Radiol J 1994;45:193-200.
- Komarniski CA, Cyr DR, Mack LA et.al. Prenatal diagnosis of schizencephaly. J Ultrasound Med 1990;9:305-307.
- Barkovich AJ, Kjos BO. Schizencephaly: Correlation of clinical findings with MR Characteristics. Am J Neuroradiol 1992;13:85-94.