Lancet neurology
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Review
Malformations of cortical development: burdens and insights from important causes of human epilepsy.
Malformations of cortical development (MCD) are important causes of chronic epilepsy in human beings. A blanket term, MCD encompasses many varied developmental disorders with diverse clinical manifestations in patients that neurologists, paediatricians, and learning disability psychiatrists will encounter. ⋯ Clinical and imaging features, genetic aetiologies, treatments, and the insights that have resulted from MCD study are covered. The burden of epilepsy due to MCD is significant and there is still much to learn about MCD.
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Diffusion-weighted MRI (DWI) has already had a substantial effect on the diagnosis of patients with ischaemic stroke. It provides in vivo pathological information and allows the differentiation of acute stroke from chronic stroke and from non-specific white-matter lesions. The high contrast of the acute DWI lesion against the dark background facilitates the detection of lesions even when they are 1 mm or less in diameter. ⋯ The latter constitute remnants or "footprints" of recent ischaemia and confirm the clinical TIA syndrome as ischaemic. Because of these attributes, DWI not only confirms the clinical diagnosis, but also facilitates the recognition of certain patterns of ischaemia, thereby providing clues to the underlying aetiology. DWI is becoming an important technique for optimum management of patients.