Multicystic Encephalomalacia in Early Infancy: A Neuroimaging Case Report.

Multicystic encephalomalacia (MCE) is an uncommon but severe consequence of perinatal hypoxic-ischemic injury in neonates. We report a 1.5-month-old male infant presenting with fever and focal seizures, with a prior history of birth asphyxia and prolonged neonatal intensive care unit stay. Neurosonography and magnetic resonance imaging revealed extensive bilateral cortical and subcortical cystic changes with cerebral atrophy consistent with MCE. This case highlights the importance of early neuroimaging to identify characteristic patterns of extensive cystic degeneration, enabling timely prognostication, seizure management and counseling of caregivers regarding long-term neurodevelopmental outcomes.