46 year-old woman with refractory seizures since age 15
Axial FLAIR and T2
Axial T1 noncontrast
Coronal STIR (inverted)
band of abnormal tissue in the subcortical white matter that
follows gray matter signal intensity and demonstrates multiple spicules
of extension to the cortex
Discussion:Gray matter heterotopia are collections of nerve cells in abnormal locations secondary to arrest of radial migration of neurons.
Although it may be confused in some cases with leukodystrophy, the
abnormal tissue follows gray matter on all pulse sequences and the
appearance is essentially pathognomonic. Patients with
heterotopic gray matter almost always present with seizures.
Heterotopia is often divided into three groups: subependymal ,
focal cortical and band. Band heterotopia is more commonly
seen in females (90%).
Submitted by Asako Miyakoshi, MD, UW Neuroradiology
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