Sudden unconsciousness

A 13-year-old male child suddenly fainted at home. He flew from Bangalore to Chandigarh yesterday. Weight: 35-36 kg. Past history: He has a previous history of headaches and convulsions. He also has a walking abnormality in his left leg from birth. He walks on his toes on the left side. The doctor suggested an MRI brain after this episode of unconsciousness. Currently I do not have his previous reports. Please give your valuable opinion. And feel free to ask any query.



Porencephaly is an extremely rare disorder of the central nervous system in which a cyst or cavity filled with cerebrospinal fluid develops in the brain. It is usually secondary to vascular event in perinatal period, history of birth asphyxia during labour, important to elicit related history Porencephalic cyst causes convulsions, therefore EEG may be helpful in further diagnosis Episode of unconsciousness may be related to convulsion

Porencephaly is an extremely rare cephalic disorder involving encephalomalacia. It is a neurological disorder of the central nervous system characterized by cysts or cavities within the cerebral hemisphere. Porencephaly was termed by Heschl in 1859 to describe a cavity in the human brain.. I think Neurosurgeion is the best desirable person to give an opinion snd line of treatment.

MRI report cystic area communicating with subarachnoid space suggestive porencephalic cyst. The boy has left sided spasticity especially in the lower limb since the time he started walking.Walking difficulty is due to rt frontal lesion. Gliosis also mentioned probably a birth injury resulting all the proble. Posting the MRI film is better for better comments. Seizures can explained with the rt frontal lesion. If the cyst under tension, only can produce head ache for which ,I would like to see the films. Is he on Anticonvulsant? Pl check the history regarding medication he is taking .Sleep deprivation,missing the med are the common cause of recurrence of seizure.

Porencephalic cyst, causing episodic headache and convulsions Toe walking on left leg, may be due to spastic or tight gastrosoleus muscles Need Neurosurgeon's opinion for porencephalic cyst For toe walking correction, may require Achilles tendon elongtion through Z-plasty.. Orthopedic opinion

Thank you sir @Dr. Ashok Leel

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? Porencephaly , right frontal lobe ? Subarachnoid Cyst . Suggest EEG Need to continue Anti Epileptic prophylaxis, if EEG is abnormal . DD for walking on toe ,- Congenital shortening of Achillis tendon. Ortho opinion may be obtained ..

Thank you,Doctor

Dx-porencephaly brain. All symptoms like headche convusions walking abnormality in left leg unconsciousness all contributed to the lesion porecephaly since birth. Rx-1-antiepilectic drugs continued. 2-spasticity and contracture in left limb may be corrected -orthopaedic opinion must. 3-if sign and symptoms severe then neurosurgery may benifit the pt. Neurosurgical consulation needed.

Gliotic area in rt frontal lobe communicating with subarachnoid forming proencephelic cyst Is presenting convulsions and unconsciousness Neurologist has role and should be in team

Thanx Nihar Ranjan Mohanty

Glioosis with arachnoid cyst frontal lobe should not have lower limb problem. Pl try to rule out local cause also. Definitely neurological symptoms are related

Porencephalic Cyst is responsible for headache and convulsion. Needs further investigation and evaluation to conclude and line of treatment. Regular monitoring and constant evaluation required.

Thanks dear Nihar

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Porencephaly... is rare condition... I agree with Dr. Jayesh’s opinion. Anti epileptic are recommended....

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