Abstract
Sturge-Weber syndrome (SWS) is a rare congenital neurocutaneous disorder characterized by facial port-wine stains, leptomeningeal angiomas, and various ocular abnormalities. Serial neuroimaging provides critical insights into disease progression. We report a longitudinal case of a female patient with SWS followed from one month to 12 years of age. Imaging demonstrated leptomeningeal angiomas, progressive underlying brain atrophy, cortical calcifications, choroid plexus enlargement, and hemi-calvarial hypertrophy correlating with the patient's clinical deterioration and seizure activity. This case highlights the predictable evolution of radiological features in SWS and underscores the importance of early MRI evaluation for confirming the diagnosis and long-term imaging follow-up for management, as well as prognostication.