DOI: https://doi.org/10.36347/sjmcr.2026.v14i05.105

Pages: 1305-1308

Hypoxic–ischemic brain injury [HIBI] is a major cause of chronic neurological disability, particularly following perinatal asphyxia. The perirolandic cortex, which includes the primary motor and somatosensory areas, is especially vulnerable to hypoxic–ischemic insults. To describe the clinical presentation and magnetic resonance imaging [MRI] features of perirolandic cortico-subcortical atrophy in patients with chronic sequelae of hypoxic–ischemic brain injury. We report three patients with a history of neonatal distress or early hypoxic–ischemic injury who presented with long-term motor and neurodevelopmental impairment. MRI findings were analyzed with particular attention to perirolandic involvement and associated white matter and deep gray matter abnormalities. All patients demonstrated bilateral perirolandic cortico-subcortical atrophy associated with white matter gliosis, secondary ventricular dilatation, and corpus callosum atrophy. One patient also showed basal ganglia and thalamic involvement, reflecting a more severe hypoxic–ischemic insult. Perirolandic cortical atrophy represents a characteristic MRI pattern of chronic hypoxic–ischemic brain injury and correlates with persistent motor and functional deficits.