Toshio Moritani MD, PhD, Presenter: Nothing to Disclose

Wendy R.K. Smoker MD, Abstract Co-Author: Nothing to Disclose

Yutaka Sato MD, Abstract Co-Author: Nothing to Disclose

Per-Lennart Alwe Westesson MD, Abstract Co-Author: Nothing to Disclose

1. Learn the various pathological conditions with unilateral involvement of an entire cerebral hemisphere2. Understand pathology and pathophysiology of “holohemispheric” processes

Various imaging modalities, including plain radiography, CT, MRI and MR angiography, were used to evaluate over 50 patients with a variety of pathological conditions affecting an entire cerebral hemisphere. These include hemispheric involvement related to status epilepticus, hemiconvulsion-hemiplegia epilepsy (HHE) syndrome, Rasmussen encephalitis, and Sturge-Weber syndrome. The differntial diagnosis of these lesions include herpes simplex encephalitis, human herpes virus 6 encephalitis, large cerebral infarction, hemimegalencephaly, and gliomatosis cerebri. MR findings are useful in the differential diagnoses. Diffusion-weighted imaging showed decreased ADC values in the early phase of hemispheric involvement related to seizures including those associated with HHE syndrome. Gadolinium-enhancement is useful in the differential diagnosis, showing various enhancement patterns. We discuss the definition and pathophysiology of these entities including Dyke-Davidoff-Masson syndrome.

Moritani, T, Smoker, W, Sato, Y, Westesson, P, Differential Diagnosis of "Holohemispheric" Pathology.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4416824.html