Presentation
Seizure.
Patient Data
Multifocal cortical malformations, manifesting as an abnormal thickened gyral pattern with increased cortical thickness and irregularity of the cortical-white matter junction due to the packing of microgyria in both cerebral hemispheres is suggestive for polymicrogyria.
Subcortical gray matter nodular heterotopia also is seen in the left frontal lobe.
Case Discussion
The numerous small gyri that lend their name to the condition are very small and only seen on thin section high-resolution MRI, and even then may be difficult to distinguish from pachygyria, as both as associated with broad enlarged and often thickened gyri.
The grey-white junction is often the best location to identify the 'bumpy' contour which on thicker slices may manifest as blurring.
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