Multiple areas of encephalomalacia with cyst formation in infants have been reported associated with a variety of conditions. Thrombosis of the superior longitudinal sinus was apparently responsible in some cases, while in others there was a related infection, intoxication, or gastrointestinal disturbance. Cases have also been recorded in which no associated disease was apparent. The inconstancy of the clinical manifestations and the variations in the central nervous system pathology indicate that thls condition may be produced by several ,disease processes. The cases in this report are illustrative of two different mechanisms of production of the characteristic lesions.
C A S E R E P O R T SCase 2. T. R., a male infant, was the fourth child of a 39 year old mother. His delivery was spontaneous following a nine hour labor. He was cyanotic a t birth and required artificial resuscitation. On the second day of life, transient convulsive movements appeared in the right upper and lower extremities and recurred a t intervals over a period of several days. In the following weeks all four extremities gradually became increasingly rigid. Nourishment was taken poorly and feedings were frequently refused. Bottle feedings were necessary until the age of four years. The patient experienced great difficulty in learning to sit erect and walk, and he appeared mentally retarded. A t three years of age convulsive attacks appeared. They characteristically began with a cry followed by a loss of consciousness and involuntary urination. The head was bent backwards and all four extremities were stiffly extended. The episodes were of three to five hours duration and initially occurred a t approximately three-month intervals. The attack-free interval subsequently lengthened to six months. On January 21, 1952, at the age of 8% years,