Answer of March 2005

Clinical History:

M/45. Head injury in infancy.

                                              Fig.1

                                                Fig.2

Diagnosis:

Dyke-Davidoff-Masson syndrome

Discussion:

Figure1 : right cerebral atrophy with prominent CSF space . 
Figure2: thickening of skull vault and overdevelopment of frontal sinuses on right side . 

Cerebral hemiatrophy or Dyke-Davidoff-Masson syndrome is a condition characterized by seizures, facial asymmetry, contralateral hemiplegia or hemiparesis, and mental retardation. These findings are due to cerebral injury that may occur early in life or in utero. The radiological features are unilateral loss of cerebral volume and associated compensatory bone alterations in the calvarium, like thickening, hyperpneumatization of the paranasal sinuses and mastoid cells and elevation of the petrous ridge.