Cerebral hemiatrophy: a clinicopathological report of two cases with a contribution to pathogenesis and differential diagnosis.

"Cerebral hemiatrophy" describes a condition of different etiologies that is characterized by a marked asymmetry of cerebral hemispheres. Case reports of two different forms of cerebral hemiatrophy are presented. In the first case perinatal asphyxia led to severe white matter lesions with predominance on the left side and marked asymmetry of the pyramidal tracts. Symptoms were present immediately after birth ("primary cerebral hemiatrophy"). The second case displayed postictal cerebral hemiatrophy with a widespread loss of cortical neurons of the entire left hemisphere. The disease process started at the age of two years after a widely normal early development ("secondary cerebral hemiatrophy"). A modified classification of cerebral hemiatrophy is presented, and concepts of pathogenesis and differential diagnosis are discussed.