Adult Onset Porencephaly in a Female Patient with Hypertension and Type 2 Diabetes Mellitus – A Case Report

Porencephaly is a rare neurological disorder characterized by cerebrospinal fluid (CSF)-filled cavities within the cerebral hemispheres.It may be congenital, resulting from abnormal neuronal migration (genetic type), or due to late prenatal/perinatal vascular insults such as ischemic stroke or venous thrombosis (encephaloclastic type).Acquired adult-onset forms are extremely rare and occur secondary to trauma, infarction, hemorrhage, or focal encephalitis.Clinical manifestations include seizures, cognitive decline, motor weakness, or subtle focal deficits, although some cases remain undiagnosed without any symptoms.We report the case of a 46-year-old woman with right-sided porencephaly presenting with recurrent falls, generalized weakness, and a seizure disorder, in the background of hypertension, type 2 diabetes mellitus (T2DM), primary hypothyroidism, and multiple cerebrovascular infarcts.This case emphasizes the diverse etiologies and variable presentations of porencephaly and highlights the role of clinicoradiological correlation in differentiating it from other intracranial cystic lesions, such as arachnoid cyst, schizencephaly, ependymal cyst, encephalomalacia, and hydranencephaly.