Atypical subependymal giant cell astrocytoma and neonatal tuberous sclerosis

Godoy LL, Ferreira Alves CAP. Atypical subependymal giant cell astrocytoma and

neonatal tuberous sclerosis. Neurology. 2018 Mar 20;90(12):570-571.

A 9-day-old girl had, on prenatal ultrasound, brain and cardiac lesions suspicious for tuberous 
sclerosis. Brain MRI demonstrated a large intraventricular and intraparenchymal mass centered on the foramen of Monro, which had unusual imaging findings: a homogeneous T1-hyperintense and T2-hypointense signal (figure 1, A and B) related to scarce myelination; remarkable venous drainage on susceptibility-weighted imaging (figure 1C); and apparent diffusion coefficient hypointensity, corresponding to blackout T2 effect (figure 2, A and B). Spectroscopy showed increased choline and myo-Inositol peaks (figure 2C). These findings are consistent with neonatal subependymal giant astrocytoma.1,2 Subependymal nodules, cortical tubers, and radial bands were also atypically T1-hyperintense and T2-hypointense (figure 1, A and B).