[Schizencephaly associated with porencephaly in a girl with congenital cytomegalovirus infection].

INTRODUCTION: At the present time it is perfectly clear that schizencephaly is an anomaly of neuronal migration and porencephaly is the result of destruction of the cerebral cortex. Schizencephaly is the final result of a variety of lesions which occur during a critical period of the development of the brain. Imaging studies have shown many cerebral anomalies varying from lissencephaly to multicystic encephalomalacia. We report the case of a girl in whom porencephaly was associated with schizencephaly and in whom angioresonance showed hypoplasia of the right middle cerebral artery.

CLINICAL CASE: The parents of an eight month old girl consulted us after observing that she had reduced movement of her left arm. On clinical examination there was left hemiparesia. Both CAT and MR showed closed lip schizencephaly of the left hemisphere and an area of right frontoparietal encephalomalacia. Study of the vascular structures showed underdevelopment of the right middle cerebral artery.

CONCLUSIONS: The cytomegalovirus has been considered to be the principal infectious agent involved in the aetiology of different disorders of neuronal migration. It has been reported that the cytomegalovirus causes vasculitis which leads to reduction in perfusion and lesions due to secondary encephalomalacia. The fact that our patient had a hypoplastic middle cerebral artery, and a normal left middle cerebral artery, may be explained by subsequent recanalization of the middle cerebral artery. This would seem to indicate that the lesion causing schizencephaly is older and there has been time for recanalization.