Post-Traumatic Porencephaly in Infancy

Abstract

A good deal of confus ion exists concern ing the t e r m p o r e n c e p h a l y which was first used b y Hesch l s in his r epo r t in 1859. Pseudoporencepha ly 11 a n d v e n t r i c u l a r d iver t icula a are b u t two of t he express ions appl ied to va r i a t ions in t he a p p e a r a n c e of these lesions. I n an effort to avo id m i s u n d e r s t a n d i n g , D r e w and G r a n O en t i t l ed the i r r epo r t B e n i g n Cys ts of the B r a i n . F o r the pu rpose of th i s discussion we h a v e used t he t e r m as def ined b y L e C o n n t and Semarak , n a defect c o m m u n i c a t i n g w i th the ventr ic les or separ a t ed f rom t h e m b y a t h i n layer of b r a in t issue and covered on t h e outs ide by a r achno id . T h e et iology of such cysts is diverse and m a y be b road ly classified as deve lopmen ta l or acquired. I n his excel lent review of the l i te ra ture , Naef 14 has n o t e d t he chang ing views concern ing the pa thogenes i s of th i s condi t ion. Acqui red porencepha ly is due to des t ruc t ion of cerebral t issue a t a n y t i m e a n d f rom various causes such as t r a u m a , c i r cu la to ry d is turbances , or in f l ammato ry or degene ra t i ve processes. T h e i m p o r t a n c e of t r a u m a a t b i r t h or in t he n e o n a t a l pe r iod was emphas ized b y Jaff6 in 19292 ~ His case was t h a t of a ~0-year-old w o m a n who h a d suffered severe t r a u m a shor t ly a f t e r b i r th . Since t h a t t i m e few reports of po rencepha ly following t r a u m a in infancy have appeared . I n the series of D r e w a n d G r a n t 4 only 1 of the 30 cases f i t ted i n to th i s category, and in ~ o the r series the inc idence was on ly * in ~ and 1 in 3~. 14 I n t he re la t ive ly s h o r t per iod of 6 m o n t h s we h a v e h a d t he o p p o r t u n i t y of seeing 3 unusua l cases of p o r e n c e p h a l y occurr ing in infancy. E a c h of these appea r s to be t r a u m a t i c in origin, and these cases fo rm the bas is of th i s report .