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Fig 7. SWS. This 7-year-old boy was originally seen at 18 days of life and diagnosed with SWS on the basis of findings of bilateral port-wine stains involving the face, trunk, back, and thigh without evidence of hemihypertrophy. Findings of his electroencephalography were normal as were the findings of his neurologic examination. A CT scan in the neonatal period (not available) suggested prominent veins in the right meninges near the Sylvian fissure. His first MR imaging scan at 7 months (not shown) demonstrated intense contrast enhancement of the vascular structures of the right parietal and occipital regions. Follow-up MR imaging at age 5 years is shown. A mildly enlarged deep subependymal vein along the right lateral ventricle is visible (arrows) on a T2-weighted image (A), contrast-enhanced T1-weighted image (B), and SWI (C). The postcontrast T1-weighted image (B) also reveals additional prominently enhancing right subcortical and deep medullary veins (open arrows). However, SWI (C) best delineates these prominent veins related to abnormal venous drainage in this condition and also shows a subtly prominent left subependymal vein (arrowhead), indicating early contralateral involvement. He has been developing normally, and his facial lesions have been treated with cosmetic laser surgery. He has had no evidence of seizures or other neurologic symptoms but is being treated for glaucoma.
