Striking MRI Changes of Focal Cortical Dysplasia Over Time

Abstract

Purposeof review: Brain MRI findings of focal cortical dysplasia (FCD) can undergo dramatic changes over time, which may be related to long-term epilepsy or a combination of histopathologic changes that necessitate further investigation.Recent findings:We describe two cases of FCD Type IIb that initially displayed inconspicuous findings on MRI, however progressed to obvious signal changes on subsequent MRI 10-17 years later. Pathologic analysis indicates that the interval changes are likely attributed to reactive astrogliosis and diffuse parenchymal rarefaction. A few case reports and case series showing similar MRI changes have been described in the literature, the majority in pediatric patients. The adult cases we present add to the scientific evidence of these changes occurring in the adult population.Summary:Our observations lead to several clinical suggestions, including closer interval follow up imaging for non-lesional cases, the addition of post-processing imaging methods, earlier surgical intervention, and meticulous surgical planning.

The Role of the Three-Dimensional Edge-Enhancing Gradient Echo Sequence at 3T MRI in the Detection of Focal Cortical Dysplasia: A Technical Case Report and Literature Review

“…However, while the abnormality is too subtle to create pronounced MR signal alternations, there are no obvious contrast between the FCDs and surrounding tissues, that will not be detected on MRI (Figures 1 A, B, C, and D). Adina Achiriloaie et al (11) reported that conventional MRI sequences that shows to be negative at the the FCDs and the part of normal GM or WM. To a certain degree ， it can magnify shows the lesion of FCDs.…”

“…1A–D ). Achiriloaie et al 11 reported that conventional MRI sequences that shows to be negative at the early stage might change and lesions may appear after years, especially whom has high seizure frequency. But it generally takes a long time.…”