|Patient: 32 year old male|
|History: male: with worsening migraine headaches and gait changes. Remote history of collapse with shaking of right arm.|
|Findings: Axial T2 weight MR image through the lateral ventricles which demonstrates an irregular, nodular contour along the posterolateral surface of the left ventricle.|
Heterotopia: disorganized brain tissue, usually gray matter, located in the wrong place.
Due to premature arrest of neuronal migration from the periventricular germinal matrix to the cortex.
Symptoms may include: seizures, weakness, spasticity, and developmental delay.
Two main types: Nodular and band
Tuberous Sclerosis: Neurocutaneous disorder that is usually spontaneous (60%), although may be autosomal dominant.
Classic triad: adenoma secaceum, seizures, and mental retardation found in only 33%.
Associated with angiomyolipomas, multiple bone islands, pulmonary lymphangioleiomyomatosis
Subependymoma: Ependymal cell neoplasm, variant of ependymoma.
Most commonly in the fourth ventricle, elderly males.
May also arise in the lateral ventricles and septum pellucidum although less likely.
Tend to not seed the CSF, unlike ependymomas.
Benign course and noninvasive. Excission is curative.
Cytomegalovirus: A herpes virus causing disease usually in the fetus, neonate, and immunocompromised.
Most common TORCH infection.
Maternal transmission from reactivation (3.4% risk) or primary infection (up to 50% risk).
Clinical symptoms range from asymptomatic to microcephaly, ocular abnormalities, and hearing loss.
May have periventricular calcifications, but limited to subependymal region.
Toxoplasmosis: Ubiquitous protozoan parasite
Second most common TORCH infection.
Maternal transmission usually from primary maternal infection.
Clinical symptoms include hydrocephalus and chorioretinitis.
TORCH infection that most commonly calcifies.
Treatment can reduce or eliminate intracerebral calcifications.
Calcifications frequently periventricular, however may be elsewhere in parenchyma including curvilinear calcifications within the basal ganglia.
Yousem DM, Grossman RI; Neuroradiology: the requisites (3rd edition). Mosby Elsevier 2010.
Weissleder, Wittenberg, Harisinghani, Chen; Primer of Diagnostic Imaging (4th edition). Mosby Elsevier 2007.
Genetics Reference, U.S. National Library of Medicine. http://ghr.nlm.nih.gov/condition/periventricular-heterotopia
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Case Number: 48174467Last Updated: 11-09-2010 The reader is fully responsible for confirming the accuracy of this content.