Hemimegalencephaly

5month old with delayed mile stones and partial seizures. 

EEG revealed asymmetric suppression burst patterns.

Findings:

There is obvious asymmetry in volume of cerebral hemispheres and basal ganglia.

At first impression it appears to be left Hemiatrophy due to prominence of left hemispheric cortical sulci. 

But..

This prominence of hemispheric cortical sulci and wide cranio cortical distance are common and normal findings for the age of 5month.

Actually right hemisphere and basal ganglia are larger in volume compared to left.

If u see carefully convolution pattern on lateral surface of right cerebral hemisphere is non uniform. In temporal and frontal region there are relative excessive small convolutions where as in parietal region cortical gyri are thick with sparsity of cortical sulci compared to opposite side where convolution pattern is uniform.

.....Right Hemimegaencephaly.