Syndromes of Bilateral Symmetrical Polymicrogyria
A. James Barkovich
,a,
Robert Hevnera and
Renzo Guerrinia
a From the Department of Radiology, Section of Neuroradiology (A.J.B.), and the Ireland Research Laboratory, Langley Porter Psychiatric Institute (R.H.), University of California San Francisco; and the Institute of Child Neurology and Psychiatry, Pisa, Italy (R.G.).
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FIG 1. Case 1: 3-year-old girl with bifrontal polymicrogyria. Axial spin-echo (SE) (600/20) MR image shows shallow sulci with irregularity or the cortical–white matter junction, consistent with polymicrogyria, involving the entire frontal cortex posteriorly to the central sulcus.
FIG 2. Case 15: 10-month-old girl with bilateral holosylvian polymicrogyria.
A, Axial reformation from 3D Fourier transformation (3DFT) gradient-echo (GRE) (35/7) image shows thickened, irregular cortex involving the entirety of the cortex surrounding the sylvian fissures and widening of the fissures.
B, Sagittal reformation from 3DFT GRE (35/7) image shows that the entire perisylvian cortex (arrows) is abnormal.
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FIG 3. Case 12: 31-year-old man with bilateral posterior sylvian polymicrogyria.
A, Axial SE (2500/80) image shows normal anterior perisylvian cortex, with thickening of the cortex (arrows) posteriorly.
B, Sagittal SE (600/20) image shows that the abnormal posterior perisylvian cortex extends superiorly (arrows) to the parietal convexity.
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FIG 4. Case 19: 14-month-old boy with bilateral frontal and sylvian polymicrogyria. Axial SE (3000/120) image, obtained at age 3 months, shows polymicrogyria involving the orbital and medial surfaces of the frontal lobes and along the insular cortex. The opercula are too wide.
FIG 5. Case 16: 10-month-old girl with bilateral lateral parietal polymicrogyria. Axial SE (3000/120) image shows polymicrogyria over the parietal convexities (arrows) bilaterally.
FIG 6. Case 17: 6-year-old boy with bilateral parasagittal parieto-occipital polymicrogyria. Axial inversion-recovery (1600/16, IR = 400) image shows the irregular cortex (arrows) in a parasagittal location involving the parietal and occipital lobes.
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FIG 7. Case 20: 6-year-old boy with bilateral perisylvian and parasagittal parieto-occipital polymicrogyria.
A, Axial SE (2800/80) image shows polymicrogyria (arrows) involving the posterior perisylvian cortex and extending posteriorly and medially into the parietal parasagittal region.
B, Sagittal SE (550/11) image shows polymicrogyria continuing from the posterior sylvian area (white arrows) into the parieto-occipital area (black arrows).
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FIG 8. Case 21: 7-year-old girl with bilateral perisylvian, lateral parietal, and parieto-occipital polymicrogyria.
A, Axial SE (2000/40) image shows polymicrogyria (arrows) involving the parasagittal parieto-occipital cortex and the lateral parietal cortex.
B, Sagittal SE (600/20) image shows the polymicrogyria involving the entire perisylvian cortex (solid white arrows) and extending posteriorly into the parietal (open black arrows) and occipital (open white arrows) lobes.
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