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Short case publication... Version 2.19| Edited by professor Yasser Metwally | June 2009




                                                                                                  Short case

                                                                                                 Edited by
                                                                                         Professor Yasser Metwally
                                                                                           Professor of neurology
                                                                                       Ain Shams university school of medicine
                                                                                                  Cairo, Egypt

                                                                                            Visit my web site at:
                                                                                         http://yassermetwally.com




22 month old famale patient diagnosed clinically with Assymetric Diskenetic Cerebral Palsy (right worse then left) with
Hypotonia and Orofacial Dyskinesia.

DIAGNOSIS:  BILATERAL HYPOXIC/ISCHEMIC                        BASAL     GANGLIONIC         NECROSIS           INDUCING
EXTRAPYRAMIDAL FORM OF CEREBRAL PALSY
Figure 1. Precontrast MRI, T1 images (Axial view) showing bilateral fairly symmetrical, well circumscribed
hypointensity involving the lateral parts of the putamen and the globus pallidus indicating cystic necrosis of these
parts, most probably due to perinatal brain hypoxia/ischemia. The bilateral cysts is isointense with the CSF in the
T1 images.




 Figure 2. Precontrast MRI, T1 images (Coronal view) showing bilateral, fairly symmetrical, well circumscribed
 hypointensity involving the lateral parts of the putamen and the globus pallidus indicating cystic necrosis of these
 parts, most probably due to perinatal brain hypoxia/ischemia. The bilateral cysts is isointense with the CSF in the
 T1 images.
Figure 3. MRI T2 images. The bilateral basal ganglionic cystic necrosis is hyperintense and fairly
symmetrical. Again the basal ganglionic cysts are isointense with the CSF




                                                 Figure 4. MRI T2 (A) and T1 (B) images images
                                                 showing vertical disc herniation (Schmorl's nodule)
                                                 in the upper lumbar vertebrae
References

1. Metwally, MYM: Textbook of neurimaging, A CD-ROM publication, (Metwally, MYM editor) WEB-CD agency for
electronic publishing, version 10.2a April 2009



Addendum

   A new version of short case is uploaded in my web site every week (every Saturday and remains available till Friday.)
   To download the current version follow the link quot;http://pdf.yassermetwally.com/short.pdfquot;.
   You can download the long case version of this short case during the same week from: http://pdf.yassermetwally.com/case.pdf or visit web
   site: http://pdf.yassermetwally.com
   To download the software version of the publication (crow.exe) follow the link: http://neurology.yassermetwally.com/crow.zip
   At the end of each year, all the publications are compiled on a single CD-ROM, please contact the author to know more
   details.
   Screen resolution is better set at 1024*768 pixel screen area for optimum display
   For an archive of the previously reported cases go to www.yassermetwally.net, then under pages in the right panel,
   scroll down and click on the text entry quot;downloadable short cases in PDF formatquot;
   Also to view a list of the previously published case records follow the following link (http://wordpress.com/tag/case-
   record/) or click on it if it appears as a link in your PDF reader

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Short case...Cerebral palsy

  • 1. Short case publication... Version 2.19| Edited by professor Yasser Metwally | June 2009 Short case Edited by Professor Yasser Metwally Professor of neurology Ain Shams university school of medicine Cairo, Egypt Visit my web site at: http://yassermetwally.com 22 month old famale patient diagnosed clinically with Assymetric Diskenetic Cerebral Palsy (right worse then left) with Hypotonia and Orofacial Dyskinesia. DIAGNOSIS: BILATERAL HYPOXIC/ISCHEMIC BASAL GANGLIONIC NECROSIS INDUCING EXTRAPYRAMIDAL FORM OF CEREBRAL PALSY
  • 2. Figure 1. Precontrast MRI, T1 images (Axial view) showing bilateral fairly symmetrical, well circumscribed hypointensity involving the lateral parts of the putamen and the globus pallidus indicating cystic necrosis of these parts, most probably due to perinatal brain hypoxia/ischemia. The bilateral cysts is isointense with the CSF in the T1 images. Figure 2. Precontrast MRI, T1 images (Coronal view) showing bilateral, fairly symmetrical, well circumscribed hypointensity involving the lateral parts of the putamen and the globus pallidus indicating cystic necrosis of these parts, most probably due to perinatal brain hypoxia/ischemia. The bilateral cysts is isointense with the CSF in the T1 images.
  • 3. Figure 3. MRI T2 images. The bilateral basal ganglionic cystic necrosis is hyperintense and fairly symmetrical. Again the basal ganglionic cysts are isointense with the CSF Figure 4. MRI T2 (A) and T1 (B) images images showing vertical disc herniation (Schmorl's nodule) in the upper lumbar vertebrae
  • 4. References 1. Metwally, MYM: Textbook of neurimaging, A CD-ROM publication, (Metwally, MYM editor) WEB-CD agency for electronic publishing, version 10.2a April 2009 Addendum A new version of short case is uploaded in my web site every week (every Saturday and remains available till Friday.) To download the current version follow the link quot;http://pdf.yassermetwally.com/short.pdfquot;. You can download the long case version of this short case during the same week from: http://pdf.yassermetwally.com/case.pdf or visit web site: http://pdf.yassermetwally.com To download the software version of the publication (crow.exe) follow the link: http://neurology.yassermetwally.com/crow.zip At the end of each year, all the publications are compiled on a single CD-ROM, please contact the author to know more details. Screen resolution is better set at 1024*768 pixel screen area for optimum display For an archive of the previously reported cases go to www.yassermetwally.net, then under pages in the right panel, scroll down and click on the text entry quot;downloadable short cases in PDF formatquot; Also to view a list of the previously published case records follow the following link (http://wordpress.com/tag/case- record/) or click on it if it appears as a link in your PDF reader