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Interesting image – is something missing?
  1. Beverley Almeida, E&P
  1. Correspondence to Dr Beverley Almeida, Department of Rheumatology, Great Ormond Street Hospital, Great Ormond Street, London WC1N 3JH, UK; beverleyalmeida{at}

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Hemihydraenecephaly can be compatible with life. A 21-year-old who was known to have had developmental delay and a persistent left sided hemiplegia had brain imaging (figure 1), (never previously completed in his life), after an episode of status epilepticus to show hemihydraenecephaly. Although it is a rare condition, it is generally thought to be incompatible with life and therefore counselling if picked up antenatally should remain guarded, but perhaps a little more optimistic.

Figure 1

T1W MRI of brain, coronal view showing an absent right hemisphere replaced by cerebrospinal fluid and an occluded right internal carotid artery.

I hope you do look at the full article. I have not previously seen this finding on imaging: it does appear genuinely amazing.

Alternatively I hope this encourages you to send in your own examples of interesting images to BMJ Case Reports: a positive new development is that all published cases are now indexed on PubMed.


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  • Provenance and peer review Not commissioned; externally peer reviewed.

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