Board Review 1 – Case 12

Neuroradiology board review. This lecture is geared towards the ABR core exam for residents, but it would be useful for review for the ABR certifying exam or certificate of added qualification (CAQ) exam for neuroradiology.

More description and the answer (spoiler!) are seen below the video.

In this case, there are curvilinear calcifications which follow the cortex in the right cerebral hemisphere on CT. On MRI, there is atrophy of the right cerebral hemisphere with abnormal veins coursing through the deep white matter of the right cerebral hemisphere. On contrast enhanced images, there is avid enhancement of the right hemisphere leptomeninges.

The diagnosis is: Sturge-Weber syndrome

Sturge-Weber syndrome is a variant in which normal cortical vessels fail to form, and the hemisphere is drained by abnormal mesenchymal veins which course through the cerebral hemisphere. Classic imaging findings include cortical calcifications of one hemisphere.