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Clinical characteristics of cystic encephalomalacia in children
Lijuan Fan1,2,3, Lianying Feng4, Jing Gan1,2,3
1Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
Insights
Cystic encephalomalacia in children is primarily caused by hypoxic-ischemic encephalopathy, infections, and hemorrhage. Key symptoms include developmental delays, epilepsy, and dystonia, with MRI aiding diagnosis.
Area of Science:
- Pediatric Neurology
- Neuroimaging
- Neonatal Medicine
Background:
- Cystic encephalomalacia (CE) is a severe neurological condition in children.
- Understanding its causes and clinical features is crucial for diagnosis and management.
- Previous studies have highlighted various potential etiologies and outcomes.
Purpose of the Study:
- To investigate the primary causes of cystic encephalomalacia (CE) in pediatric patients.
- To delineate the clinical characteristics and manifestations associated with CE.
- To analyze cranial magnetic resonance imaging (MRI) features in children diagnosed with CE.
Main Methods:
- Retrospective review of clinical data from 50 children diagnosed with CE between 2008 and 2020.
- Analysis of primary causes, clinical presentations, and MRI findings.
- Statistical comparison of clinical features based on the underlying cause of CE.
Main Results:
- Hypoxic-ischemic encephalopathy (HIE), intracranial infection, and traumatic brain injury/hemorrhage were the leading causes of CE.
- Common clinical manifestations included speech/motor developmental delay (33/50), epilepsy (31/50), and dystonia (27/50).
- HIE was significantly associated with dystonia, while cerebral infarction correlated with a higher incidence of paralysis.
Conclusions:
- CE in children is predominantly linked to HIE, intracranial infections, and cerebral hemorrhage.
- Speech/motor delay, epilepsy, and dystonia are the most frequent clinical outcomes.
- Cranial MRI is essential for diagnosing CE and understanding its structural impact.
Purpose:
To investigate the primary causes and clinical characteristics of cystic encephalomalacia (CE) in children.
Methods:
The clinical data of 50 children who were admitted to our hospital due to CE between January 2008 and December 2020 were retrospectively reviewed. Their primary causes, clinical manifestations and cranial magnetic resonance imaging features were analyzed.
Results:
Among all patients, 5 had prematurity, 19 had hypoxic-ischemic encephalopathy (HIE), 13 had intracranial infection, 14 had traumatic brain injury and hemorrhage, 4 had cerebral infarction, 2 had congenital genetic diseases, and 1 had hypoglycemia. The average time from primary disease onset to CE diagnosis was 70.1 ± 61.0 days. The clinical manifestations included speech or motor developmental delay (n = 33), epilepsy (n = 31), dystonia (n = 27), limb paralysis (n = 16), and visual or auditory impairment (n = 5). Patients with HIE as the primary cause of CE had a significantly higher occurrence of dystonia, while a significantly higher incidence of paralysis was observed in those with cerebral infarction as the primary cause.
Conclusion:
CE in children is mainly caused by HIE, intracranial infection, and cerebral hemorrhage. The major clinical manifestations included speech or motor developmental delay, epilepsy, and dystonia. Magnetic resonance imaging is an important tool for the diagnosis of CE.
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