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Case Reports
. 2021 Oct-Dec;47(4):585-589.
doi: 10.12865/CHSJ.47.04.16. Epub 2021 Dec 31.

The Importance of Magnetic Resonance in Detection of Cortical Dysplasia

Fjolla Hyseni  1 , Ilir Ahmetgjekaj  2 , Valon Vokshi  3 , Keti Mamillo  4 , Valbona Biba  5 , Blerona Shaipi  6 , Migena Brati  7 , Kreshnike Dedushi  2 , Jeton Shatri  2 , Ermira Aliu  8 , Ali Guy  9 , Kristi Salihaj  5 , Rexhep Berisha  10 , Juna Musa  11
Affiliations
Case Reports

The Importance of Magnetic Resonance in Detection of Cortical Dysplasia

Fjolla Hyseni et al. Curr Health Sci J. 2021 Oct-Dec.

Abstract

Focal cortical dysplasia is a malformation of cortical development in which there are abnormalities with cortical lamination, neuronal maturation, and neuronal differentiation. It is the most common cause of medically refractory epilepsy in the pediatric population and the second/third most common etiology of medically intractable seizures in adults. Herein, we present the case of 23-years-old female patient, presenting with loss of consciousness, and convulsions. A MRI revealed a 5mm cortical thickening on either side of the posterior aspect of the right superior temporal gyrus without transmantle extension towards ventricle. This abnormal area is measured about 24x16mm and there was no evidence for mesial temporal sclerosis. Both hippocampi are normal is size, morphology and signal. These features are consistent with cortical dysplasia type 1. This case report emphasizes the importance of MRI in the detection of FCD. MRI can show no abnormalities in type 1 FCD, but when the changes are apparent, they are on the temporal lobe, and seizures presents most commonly in adults.

Keywords: Focal cortical dysplasia; cortical development; hippocampus; neuronal maturation.

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Conflict of interest statement

None to declare.

Figures

Figure 1
Figure 1
MRI of brain sequence. A: FLAIR axial plane results: cortical thickening up to 5mm on either side of posterior aspect of right superior temporal sulcus (involving the posterior aspects of both superior temporal gyrus and middle temporal gyrus). This abnormal area of cortical dysplasia is measured about 24x16mm. B: FLAIR axial plane results: cortical thickening up to 5mm on either side of posterior aspect of right superior temporal sulcus (involving the posterior aspects of both superior temporal gyrus and middle temporal gyrus). This abnormal area of cortical dysplasia is measured about 24x16mm. C: FLAIR sagital plane results: cortical thickening up to 5mm on either side of posterior aspect of right superior temporal sulcus (involving the posterior aspects of both superior temporal gyrus and middle temporal gyrus). This abnormal area of cortical dysplasia is measured about 24x16mm. D: Sequence T2 coronal plane results: cortical thickening up to 5mm on either side of posterior aspect of right superior temporal sulcus (involving the posterior aspects of both superior temporal gyrus and middle temporal gyrus). This abnormal area of cortical dysplasia is measured about 24x16mm
Figure 2
Figure 2
MRI of brain. A: T2 sequence coronal plane results: abnormal area of cortical dysplasia is measured about 24x16mm, consistent with Blumcke Type I (Taylor’s type) cortical dysplasia, “without transmantle extension” towards ventricle. B: Sequence T1 axial plane without contrast results: cortical thickening up to 5mm on either side of posterior aspect of right superior temporal sulcus (involving the posterior aspects of both superior temporal gyrus and middle temporal gyrus). This abnormal area of cortical dysplasia is measured about 24x16mm. C: T1 sequence sagital plane post contrast, no pathologic contrast enhancement is identified. D: T1 sequence coronal plane post contrast, no pathologic contrast enhancement is identified
Figure 2
Figure 2
MRI of brain. A: T2 sequence coronal plane results: abnormal area of cortical dysplasia is measured about 24x16mm, consistent with Blumcke Type I (Taylor’s type) cortical dysplasia, “without transmantle extension” towards ventricle. B: Sequence T1 axial plane without contrast results: cortical thickening up to 5mm on either side of posterior aspect of right superior temporal sulcus (involving the posterior aspects of both superior temporal gyrus and middle temporal gyrus). This abnormal area of cortical dysplasia is measured about 24x16mm. C: T1 sequence sagital plane post contrast, no pathologic contrast enhancement is identified. D: T1 sequence coronal plane post contrast, no pathologic contrast enhancement is identified
Figure 2
Figure 2
MRI of brain. A: T2 sequence coronal plane results: abnormal area of cortical dysplasia is measured about 24x16mm, consistent with Blumcke Type I (Taylor’s type) cortical dysplasia, “without transmantle extension” towards ventricle. B: Sequence T1 axial plane without contrast results: cortical thickening up to 5mm on either side of posterior aspect of right superior temporal sulcus (involving the posterior aspects of both superior temporal gyrus and middle temporal gyrus). This abnormal area of cortical dysplasia is measured about 24x16mm. C: T1 sequence sagital plane post contrast, no pathologic contrast enhancement is identified. D: T1 sequence coronal plane post contrast, no pathologic contrast enhancement is identified
Figure 2
Figure 2
MRI of brain. A: T2 sequence coronal plane results: abnormal area of cortical dysplasia is measured about 24x16mm, consistent with Blumcke Type I (Taylor’s type) cortical dysplasia, “without transmantle extension” towards ventricle. B: Sequence T1 axial plane without contrast results: cortical thickening up to 5mm on either side of posterior aspect of right superior temporal sulcus (involving the posterior aspects of both superior temporal gyrus and middle temporal gyrus). This abnormal area of cortical dysplasia is measured about 24x16mm. C: T1 sequence sagital plane post contrast, no pathologic contrast enhancement is identified. D: T1 sequence coronal plane post contrast, no pathologic contrast enhancement is identified
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