 Hello everyone, I myself am Dr. Dhanesh Arsan and chair of the department of radio diagnosis and my co-author is Dr. Mushil, senior resident of department of radio diagnosis from Jawaharlal Neuro Medical College, Aligarh Muslim University. The aim of my case study is to study a rare disease in a young child with a developmental delay. Coming to the history of the patient, a 14-year old presented with difficulty in speaking since birth with a history of frequent falls while working since one year and developmental delay is present. There is no history of any abnormal moments, seizures, trauma, fever, prenatal, natal and postnatal history are insignificant. Coming on to clinical examination. On general examination, the child is normal built with no pallor, ectress, sinosis, clubbing, lymphadenopathy and edema with normal vitals. Sleep and appetite is normal, bowel and bladder control is normal. Coming on to CNS examination, the child is conscious, oriented to time, place and person, speech was blurry and it is sartic, with writing is normal and memory is normal. On motor and sensory examination was found to be normal, with no postural sign was present. There is no cerebellar or meninges signs noted. On investigation, on today blood investigation was found to be within normal limits, EEG was within normal limits, NCCT head was advised. On axial section of NCCT head shows a cleft in bilateral frontal lobe extending from subarachnoid space into bilateral lateral ventricle, also noted abscent septum pellicidum. On coronal section, on coronal section of NCCT head shows a cleft extending from bilateral axonicum bilateral frontal lobe into the lateral ventricle with abscent septum pellicidum was noted. On coronal section of D1 and D2 weighted MRI brain shows a CSF cleft lined by thickened and irregular grey matter extending from subarachnoid space into the lateral ventricle with absent septum pellicidum noted. On coronal section of D2 weighted MRI shows a CSF cleft lined by thickened and irregular grey matter extending from the subarachnoid space into the lateral ventricle with absent septum pellicidum was noted. CIS image reconstruction shows normal bilater optic nerve and bilater optic chiasma. A MR angiography of the brain appears normal. Hence, a diagnosis on MRI is close to schism's capillary with absent septum pellicidum with normal basal ganglia under normal optic chiasma. The final diagnosis of the patient is bilater close to schism's capillary with absent septum pellicidum. Coming on to the introduction part, schism's capillary were accommodated with an instance of 1.5-1 lakh population under 1 in every 1,650 among the children suffering from epilepsy due to an inovation environment. It should be considered an infant presenting with a seizure. Majority of the cases are thought to be sporadic with no gender prediction has been noted. Neuroimaging especially MR in the children should be asked to adequately assess its patient in spite of its high hospital good patient management. Coming on to the discussion part, schism's capillary is the little meaning of the word split pain. The grey matter lined up the texans from the ventricular epantimer to the pile surface of the cortex. Clutch spans the full thickness of the upper ket hemisphere. The two types are documented. Type 1 are the closed lips where the walls of the clefts are opposed to each other and type 2 where the walls are separate from each other. Type 2 is more common than the type 1 with a 60% age of the unidirectional schism's capillary being of the open type. The clefts could be bilateral or unilateral, symmetrical or asymmetrical. It can occur anywhere in the brain. It is, however, more common in the palatal and the frontal lobe, especially in the region of sylvanic fission. Schism's capillary is often associated with other continental abnormalities such as 50-90% of the cases are associated with the agenesis of septum pellicidum composed close to underpollum microchiria, which is excessive, number of small partly fused chirae. Pachychiria, which is unusually thick convolution of the cerebral cortex and hetotropia cell, which is ectopic grey matter, and it can be associated with the septo-optic dysplasia and optic nerve hypoplasia. Coming on to clinical presentation, the patient can present with a seizure, hemiparosis, mental retardation, delayed milestones, motor defects. Patients with the type 1 are often almost normal. They may have seizure and spasticity. In type 2 abnormalities, there is usually mental retardation, seizures, hypotonia, spasticity and inability to walk or speak and blindness. Coming on to radiographic features, Schism's capillary can sometimes be bilateral and it is divided into two morphological types. In open lip type, the cleft walls are separated and are filled with CSF and it is the most common form in bilateral cases. In closed lip, the cleft walls are in opposition and it is the most common form in the unilateral cases. Most often the cleft lip involves the posterior frontal and the palatal lobes in about 70% of the cases and although the large clefts can extend to involve the temporal or the occipital lobes, isolated involvement of these lobes are uncommon. Coming on to CT scan findings, on CT scan there will be a focal v-shaped outposting or a dimple of CSF extending outward from the lateral venticle and a dysplastic grey matter lying in the cleft. These clefts can be unilateral which occurs in about 60% of cases or it could be palatal which occurs in about 40% of the cases with a prominent open lip or barely visible which will be a closed lip. Common associated abnormalities or absence septum pellucidate which occurs in about 70% of the cases under focally thin or dis genetic corpus glosum. Coming on to MRI finding, MRI is the imaging modality of the choice and enables identification of pyl ependymal cleft as well as visualization of cortical displays here under heterotrophic grey matter. In closed lip which is type 1 seen as a nipple outposting at the ependymal surface. In open lip which will be type 2 heterotrophic grey matter lined CSF cleft seen extending from the venticular to the cortical surface. And MRI is more sensitive than CT especially in delineating associated abnormalities such as cortical dysplasia which includes polymicrobial area under pachycardia under heterotrophic grey matter. The clefts follows CSF signal intensity on all the sequences. DSA or CTA or MRI have demonstrated occlusion or absence of middle cerebral rot in some cases. And coming on to case scenario in our case who was a 14 year old boy with a developmental delay with a difficulty in speaking since birth and a frequent falls while working since one year was diagnosed with a bilateral schizenkafale with absent septum pellucidum. On prenatal diagnosis increasingly schizenkafale is being diagnosed anti-natally or postpartum with cranial ultrasound. Closed lip schizenkafale is hard to identify whereas open lip forms can if a large can be readily seen. Peter schizenkafale refers to schizenkafale diagnosed in utero. Usually only open lip types can be diagnosed anti-natally. On antinatal ultrasound they may be a unilateral or a bilateral defect extending from the pile surface to a ventricular wall. They may be associated with other features such as absent KVM septum pellucidum or occasionally fetal hydrocafale as can be seen. On fetal MRI, fetal MRI is performed to confirm the cleft is a grey matter line which distinguishes the sensitivity from the poronkafale exist. It is more sensitive are detecting the closed lip schizenkafale than ultrasound. It is also used to confirm the presence of associated anomalies also. Now coming on to the management part. Management of both type of schizenkafale is conservative. It predominantly consists of rehabilitation of the symptoms that is motor defects and the mental retardation and the control of the seizures. Surgery is undertaken in some cases where there is a hydrocafale or intra-canal hypertension which most commonly occurs in the open lip form. This usually involves the insertion of the ventricular shunts. These are my references. Thank you.