PT - JOURNAL ARTICLE AU - Barkovich, A J AU - Chuang, S H TI - Unilateral megalencephaly: correlation of MR imaging and pathologic characteristics. DP - 1990 May 01 TA - American Journal of Neuroradiology PG - 523--531 VI - 11 IP - 3 4099 - http://www.ajnr.org/content/11/3/523.short 4100 - http://www.ajnr.org/content/11/3/523.full SO - Am. J. Neuroradiol.1990 May 01; 11 AB - Unilateral megalencephaly is a rare and poorly understood malformation resulting in the enlargement of all or part of a cerebral hemisphere. The clinical and radiologic features of 12 patients with unilateral megalencephaly are presented; pathologic correlation was available in four. All patients had seizures and developmental delay. Two were in congestive heart failure as a result of arteriovenous shunting through the abnormal hemisphere. The affected hemispheres showed a wide spectrum of involvement. Anomalies of neuronal migration were present, and there was a roughly inverse correlation between the severity of hemispheric involvement and the magnitude of enlargement. This correlation is explained via a proposed mechanism of a mild hemispheric insult in the middle-to-late second trimester. One patient had an extremely anomalous hemisphere that did not have characteristics of a neuronal migration anomaly and may have been a hamartomatous malformation. Our correlation of the clinical, radiologic, and pathologic features of unilateral megalencephaly, together with a theory of pathogenesis, should help elucidate this rare malformation.