Morphologic diagnoses of the cerebellum included multifocal, subacute Purkinje cell degeneration, necrosis, with Bergmann's astrocytosis, granular cell atrophy, and chronic, locally extensive encephalomalacia
with mineralization, gliosis, spongiosis, neovascularization, and gitter cell infiltration.
The most commonly demonstrated pathology was encephalomalacia
with a percent of 5.90 (n: 13).
It shows periventricular leucomalacia, multicystic encephalomalacia
, brain stem and basal ganglia changes that represent varying degrees of hypoxic-ischaemic injury.
Caption: Figure 1: The MRI brain in the child with MUT-related MMA showing predominant frontoparietal abnormalities in form of encephalomalacia
The ischemic lesion in the right basal ganglia showed chronicity and appeared as cystic encephalomalacia
; most of the cerebral/cerebellar foci were smaller than before and some disappeared in the control MRI five months after the initial evaluation (Figure 7).
A 49-year-old male with past medical history of type-1 diabetes mellitus, hepatitis B, chronic hepatitis C, intravenous drug abuse, and traumatic brain injury sustained after fall 2 years prior to presentation (with left hemisphere encephalomalacia
) with no history of gastrointestinal bleed (not on aspirin or any anticoagulation treatment at home) presented to the emergency department (ED) with headache, altered mental status, and fever for 2 days' duration.
Magnetic resonance of the orbits confirmed the result of computed tomography (CT) and revealed an area of frontal encephalomalacia
probably related to the previous trauma (Figure 3).
Hypoperfusion leads to focal encephalomalacia
, focal necrosis of both the gray matter and white matter, and eventually cystic degeneration.
The deficiency of vitamin E may lead to encephalomalacia
, muscle dystrophy, exudative diathesis, poor growth and reduced reproductive efficiency [9, 11, 12].
In the third patient, the epileptogenic area might have originated from the left hemisphere, where widespread encephalomalacia
In the follow-up during which neurological examination and brain MRI and MRV were performed with three-month intervals, thrombosis was found to have completely improved at the end of three months in seven patients, partial improvement was found in three patients and encephalomalacia
in the left fronto-temporal region in association with partial improvement was found in one patient in whom thrombosis was observed because of trauma.
, also named as cerebral softening, is an area of focal brain damage that is most commonly seen in areas with insufficient blood supply.