22 month old with microphthalmia

T1 Axial

T2 Axial

Findings:

Bilateral thickened gryi particularly in the frontal lobes

DDX:

pachygyria, lissencephaly, polymicrogyria

Diagnosis:

Symmetric Pachygyria

Discussion:

The term ‘pachygyria’ is not specific to a particular malformation but describes the gross physical appearance of the brain in association with several neuronal migration disorders – most commonly disorders relating to varied degrees of lissencephaly.

Submitted by Kevin Stevenson, MD, UW Neuroradiology Fellow