Radiology MRI

Non-contrast CT showing cortical calcifications and atrophy in the left occipital lobe in a patient with Sturge-Weber Syndrome . Due to leptomeningeal angiomatous venous plexus there are dystrophic cortical changes. In microscopy study those patients have a plexus of multiple small thin-walled telangiectatic capillaries or venules in the subarachnoid space between pia and arachnoid membranes. Diminished venous cortical draining causes cortical atrophy that can be seen on the second and third image. Cortical calcifications have "tram-track" pattern - see arrows fourth image. There is no significant contrast enhancement (not shown). Also enlarged ipsilateral sinuses are part of the intracranial findings - see FS on the first image.

Diffusion Weighted Imaging (DWI) is showing acute infarct lateral in medulla oblongata on the right side (arrows). Note high signal on DWI, low on ADC and high on T2. This represents clinically Wallenberg Syndrome that is associated with Lateral Medullary Infarct . Infarct is due to occlusion of Posterior Inferior Cerebellar Artery (PICA) . In this case the infarct is rather large, but sometimes it can be quite small. So look carefully. See also my previous post with same type of infarct: Wallenberg Syndrome - Lateral Medullary Syndrome You may also check this article: Jong S. Kim - Pure lateral medullary infarction: clinical–radiological correlation of 130 acute, consecutive patients