How can we explain this boy’s developmental delay?

This seven-year-old boy presents with autistic disorder, global developmental delay and short stature. What do we see on his imaging that can help provide some answers for him and his family amid these ongoing challenges?

SSH TSE

3D FFE Axial

This case can initially seem like a stumper. We know this is a boy with developmental delay and short stature, but this isn’t immediately obvious on his imaging. Be sure to be take note of the abnormal white matter within the subcortical U-fibers in a branching radiating pattern at the posterior left parasagittal parietal zone near the vertex. The assymetric shape of this sulcus (green arrows) versus the contralateral hemisphere (pink arrows) supports a balloon-type cortical dysplasia often associated with seizure disorder. For more neuro case review, check out MRI Online.

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