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Insights into Imaging
Fig. 17 | Insights into Imaging

Fig. 17

From: Cortical ischaemic patterns in term partial-prolonged hypoxic-ischaemic injury—the inter-arterial watershed demonstrated through atrophy, ulegyria and signal change on delayed MRI scans in children with cerebral palsy

Fig. 17

a–c MRI scan in a 14-year-old girl with a chronic left MCA infarct. Axial T2-weighted image (a), sagittal T1-weighted image (b) and Mercator map derived from the curved reconstruction of 3D T1 images (c) show the unilateral sharply demarcated cystic encephalomalacia involving the arterial territory of the left MCA. Notably, there is involvement of the left temporal lobe, the deep nuclei and the inferolateral aspect of the frontal lobe with sparing of the parasagittal region and superior frontal gyrus, i.e. the watershed. The involvement of the superior temporal lobe which is not a feature of parasagittal extension in severe partial-prolonged hypoxic-ischaemic injury in term neonates can be appreciated, especially on the sagittal image (b). The Mercator map derived from the curved reconstruction of 3D T1 images (c) confirms the unilateral left MCA territory cystic change and provides an overview comparing the left with the right side of the brain. It also shows that the inter-hemispheric fissure and superior frontal gyrus are relatively preserved (i.e. not expanded/separated through atrophy)

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