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Boeri S, Bodria M, Ammendola RM, Giacomini T, Tortora D, Nobili L, Malacarne M, Rossi A, Verrina E, Piaggio G, Mancardi MM, Severino M. Brain and spine malformations and neurodevelopmental disorders in a cohort of children with CAKUT. Pediatr Nephrol 2024; 39:2115-2129. [PMID: 38376554 DOI: 10.1007/s00467-024-06289-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 12/12/2023] [Accepted: 01/03/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND Congenital anomalies of the kidney and urinary tract (CAKUT) represent 20-30% of all birth defects and are often associated with extra-renal malformations. We investigated the frequency of brain/spine malformations and neurological features in children with CAKUT. METHODS We reviewed the clinico-radiological and genetic data of 199 out of 1,165 children with CAKUT evaluated from 2006 to 2023 (99 males, mean age at MRI 6.4 years) who underwent brain and/or spine MRI. Patients were grouped according to the type of CAKUT (CAKUT-K involving the kidney and CAKUT-H involving the inferior urinary tract). Group comparisons were performed using χ2 and Fisher exact tests. RESULTS Brain/spine malformations were observed in 101/199 subjects (50.7%), 8.6% (101/1165) of our CAKUT population, including midbrain-hindbrain anomalies (40/158, 25.3%), commissural malformations (36/158, 22.7%), malformation of cortical development (23/158, 14.5%), Chiari I anomaly (12/199, 6%), cranio-cervical junction malformations (12/199, 6%), vertebral defects (46/94, 48.9%), caudal regression syndrome (29/94, 30.8%), and other spinal dysraphisms (13/94, 13.8%). Brain/spine malformations were more frequent in the CAKUT-K group (62.4%, p < 0.001). Sixty-two subjects (62/199, 31.2%) had developmental delay/intellectual disability. Neurological examination was abnormal in 40/199 (20.1%). Seizures and/or electroencephalographic anomalies were reported in 28/199 (14%) and behavior problems in 19/199 subjects (9%). Developmental delay/intellectual disability was more frequent in kidney dysplasia (65.2%) and agenesis (40.7%) (p = 0.001). CONCLUSIONS We report a relative high frequency of brain/spine malformations and neurodevelopmental disorders in children with CAKUT who underwent MRI examinations in a tertiary referral center, widening the spectrum of anomalies associated with this condition.
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Affiliation(s)
- Silvia Boeri
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
| | - Monica Bodria
- Unit of Nephrology and Kidney Transplant, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Rosa Maria Ammendola
- Radiology Unit, Azienda Socio-Sanitaria Territoriale Della Brianza, Monza, Italy
| | - Thea Giacomini
- Department of Mental Health and Addiction, Azienda Sanitaria Locale 3, Genoa, Italy
- Neuroradiology Unit, IRCCS Giannina Gaslini, Genoa, Italy
| | - Domenico Tortora
- Child Neuropsychiatry Unit, IRCCS Istituto Giannina Gaslini, Largo G Gaslini, 5, 16147, Genova, Italy
| | - Lino Nobili
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
- Child Neuropsychiatry Unit, IRCCS Istituto Giannina Gaslini, Largo G Gaslini, 5, 16147, Genova, Italy
| | - Michela Malacarne
- Human Genetics Laboratory, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Andrea Rossi
- Department of Mental Health and Addiction, Azienda Sanitaria Locale 3, Genoa, Italy
- Neuroradiology Unit, IRCCS Giannina Gaslini, Genoa, Italy
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Enrico Verrina
- Unit of Nephrology and Kidney Transplant, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Giorgio Piaggio
- Unit of Nephrology and Kidney Transplant, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Maria Margherita Mancardi
- Child Neuropsychiatry Unit, IRCCS Istituto Giannina Gaslini, Largo G Gaslini, 5, 16147, Genova, Italy.
| | - Mariasavina Severino
- Department of Mental Health and Addiction, Azienda Sanitaria Locale 3, Genoa, Italy
- Neuroradiology Unit, IRCCS Giannina Gaslini, Genoa, Italy
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Spieth S, Hahn G. [Congenital brain malformations]. RADIOLOGIE (HEIDELBERG, GERMANY) 2024; 64:410-419. [PMID: 38639917 DOI: 10.1007/s00117-024-01300-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/19/2024] [Indexed: 04/20/2024]
Abstract
CLINICAL ISSUE Malformations of the central nervous system belong to the most common developmental disorders in humans. The clinical presentation of brain malformations is nonspecific including developmental delay, hypotonia, and/or epilepsy. The great heterogeneity concerning etiology, mechanisms of development and morphology is challenging for diagnosis and classification of brain malformations. Thereby recognizing specific malformations is essential for optimal patient management and prognostic evaluation. The aim of this article is to give an overview of several clinically relevant brain malformations occurring from different disrupted developmental processes in brain formation. STANDARD RADIOLOGICAL METHODS Several brain malformations are already diagnosed during routine ultrasound in pregnancy. However pre- and postnatal magnetic resonance imaging remains the gold standard in detecting the partially subtle changes and to classify the malformations. METHODICAL INNOVATIONS Advances in pre- and postnatal neuroimaging techniques and increasing investigation of genetic mechanisms underlying brain formation and its abnormalities have led to a better understanding of embryologic development and pathogeneses of brain malformations. CONCLUSION Besides patient's history and clinical phenotype, neuroimaging plays a key role in diagnosis. Not always a specific diagnosis can be made, but neuroimaging patterns often enable a focused genetic testing and therefore are revolutionary for etiologic and prognostic assignment. Basic knowledge of brain development facilitates understanding and classifying of structural brain abnormalities.
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Affiliation(s)
- Stephanie Spieth
- Institut und Poliklinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland.
| | - Gabriele Hahn
- Institut und Poliklinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland
- Pädiatrische Radiologie, Universitäts-Kinderspital beider Basel, Spitalstraße 33, 4056, Basel, Schweiz
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Khandelwal S, Dhande R, Gowda H, Mishra G, Khandelwal R. Rhombencephalosynapsis With Obstructive Hydrocephalus: A Rare Presentation of the Cerebellar Anomaly on MRI Findings. Cureus 2023; 15:e39969. [PMID: 37416012 PMCID: PMC10320735 DOI: 10.7759/cureus.39969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 06/05/2023] [Indexed: 07/08/2023] Open
Abstract
Rhombencephalosynapsis is an exceptionally uncommon cerebellar anomaly characterized by the absence or underdevelopment of vermal axons, the presence of dentate nuclei, and the fusion of cerebral hemispheres. Depending on the presence or absence of additional supratentorial anomalies, the prognosis and clinical appearance can vary widely. Here, we present the case of a consanguineous-parent newborn boy, aged four days, who was diagnosed with the use of an MRI. The child had spastic diplegia, bone anomalies, and facial dysmorphism. Slight hydrocephalus, hypogenesis of the corpus callosum, and agenesis of the septum pellucidum were some of the additional supratentorial abnormalities. This study details the clinical and MRI findings, as well as a possible etiology, of this illness.
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Affiliation(s)
- Shreya Khandelwal
- Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Rajasbala Dhande
- Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Harshith Gowda
- Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Gaurav Mishra
- Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Sarma A, Pruthi S. Congenital Brain Malformations- Update on Newer Classification and Genetic Basis. Semin Roentgenol 2023; 58:6-27. [PMID: 36732012 DOI: 10.1053/j.ro.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 11/16/2022] [Indexed: 12/31/2022]
Affiliation(s)
- Asha Sarma
- Department of Radiology, Vanderbilt University Medical Center, Monroe Carell Children's Hospital, Nashville, TN.
| | - Sumit Pruthi
- Department of Radiology, Vanderbilt University Medical Center, Monroe Carell Children's Hospital, Nashville, TN
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5
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Vekemans M, Maurice P, Lachtar M, Blondiaux E, Jouannic J, Burglen L, Rodriguez D, Garel C, Valence S. Additional evidence for the vascular disruption defect hypothesis in a novel case of brainstem disconnection syndrome. Birth Defects Res 2022; 114:1298-1306. [DOI: 10.1002/bdr2.2100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 09/08/2022] [Accepted: 09/17/2022] [Indexed: 11/12/2022]
Affiliation(s)
- Marie‐Aricie Vekemans
- Département de Neuropédiatrie Hôpital Armand Trousseau, APHP, Sorbonne Université Paris France
| | - Paul Maurice
- Département de Médecine Fœtale Hôpital Armand Trousseau, APHP, Sorbonne Université Paris France
| | - Mohamed Lachtar
- Département de Néonatologie Hôpital Armand Trousseau, APHP, Sorbonne Université Paris France
| | - Eléonore Blondiaux
- Département de Radiopédiatrie Hôpital Armand‐Trousseau, APHP, Sorbonne Université Paris France
| | - Jean‐Marie Jouannic
- Département de Médecine Fœtale Hôpital Armand Trousseau, APHP, Sorbonne Université Paris France
| | - Lydie Burglen
- Centre de Référence Maladies Rares “Malformations et Maladies Congénitales du Cervelet,” Département de Génétique Hôpital Armand Trousseau, APHP, Sorbonne Université Paris France
- Developmental Brain Disorders Laboratory Imagine Institute, INSERM UMR 1163 Paris France
| | - Diana Rodriguez
- Département de Neuropédiatrie Hôpital Armand Trousseau, APHP, Sorbonne Université Paris France
| | - Catherine Garel
- Département de Radiopédiatrie Hôpital Armand‐Trousseau, APHP, Sorbonne Université Paris France
| | - Stéphanie Valence
- Département de Neuropédiatrie Hôpital Armand Trousseau, APHP, Sorbonne Université Paris France
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Raslan IR, Barsottini OG, Pedroso JL. A Proposed Clinical Classification and a Diagnostic Approach for Congenital Ataxias. Neurol Clin Pract 2021; 11:e328-e336. [PMID: 34484907 DOI: 10.1212/cpj.0000000000000966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 08/03/2020] [Indexed: 01/12/2023]
Abstract
Purpose of Review This review proposes a clinical classification for congenital ataxias based on clinical features, neuroimaging, and course of the disease. Recent Findings Congenital ataxias are an unusual group of neurologic disorders, with heterogeneous clinical and genetic presentation. Typical clinical features of congenital ataxias include variable degrees of motor developmental delay, very early onset cerebellar ataxia, cognitive impairment, and hypotonia, frequently mistakenly diagnosed as cerebral palsy. Congenital ataxias are usually nonprogressive. Neuroimaging plays an important role in the characterization of congenital ataxias. Despite the development of genetics with exome sequencing, several congenital ataxias remain undetermined, and medical literature on this topic is scarce. Summary A didactic classification based on the clinical and neuroimaging features for congenital ataxias include the following 4 main groups: cerebellar malformation, syndromic congenital ataxias, congenital cerebellar hypoplasia, and pontocerebellar hypoplasia. A diagnostic approach for congenital ataxias is proposed, and its differential diagnosis is also discussed.
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Affiliation(s)
- Ivana Rocha Raslan
- Ataxia Unit, Department of Neurology, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Orlando G Barsottini
- Ataxia Unit, Department of Neurology, Universidade Federal de São Paulo, São Paulo, Brazil
| | - José Luiz Pedroso
- Ataxia Unit, Department of Neurology, Universidade Federal de São Paulo, São Paulo, Brazil
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7
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Miller E, Orman G, Huisman TAGM. Fetal MRI assessment of posterior fossa anomalies: A review. J Neuroimaging 2021; 31:620-640. [PMID: 33964092 DOI: 10.1111/jon.12871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 04/12/2021] [Accepted: 04/14/2021] [Indexed: 11/27/2022] Open
Abstract
Prenatal ultrasound (US) is the first prenatal imaging tool for screening and evaluation of posterior fossa malformations since it is noninvasive, widely available, and safe for both mother and child. Fetal MRI is a widely used secondary technique to confirm, correct, or complement questionable US findings and plays an essential role in evaluating fetuses with suspected US findings and /or positive family history. The main sequences of fetal MRI consist of T2-weighted (T2w) ultrafast, single-shot sequences. Axial, coronal, and sagittal images are typically acquired allowing for a detailed evaluation of the posterior fossa contents. Also, various complimentary sequences, such as T1w, T2*w gradient sequences, or advanced techniques, including diffusion-weighted imaging, diffusion tensor imaging, and magnetic resonance spectroscopy, may provide additional information based on the studied malformation. Inclusion of these techniques should be done with careful risk-benefit analysis. The use of fetal MRI also aims to evaluate for associated anomalies. In addition, prenatal diagnosis of posterior fossa malformations is still a challenge but advances in knowledge in human developmental anatomy, genetic, and imaging recognition patterns have enabled us to shed some light on prognostic information that will help with the counseling of families. Finally, high-resolution late third trimester fetal MRI offers a safe alternative to early postnatal MR imaging, basically taking advantage of the uterine environment as a kind of "maternal incubator." Our goal is to discuss the spectrum of prenatal posterior fossa pathologies that can be studied by fetal MRI and their key neuroimaging features.
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Affiliation(s)
- Elka Miller
- Department of Medical Imaging, CHEO, University of Ottawa, Ottawa, Ontario, Canada
| | - Gunes Orman
- Edward B. Singleton Department of Radiology, Texas Children's Hospital, Houston, Texas, USA
| | - Thierry A G M Huisman
- Edward B. Singleton Department of Radiology, Texas Children's Hospital, Houston, Texas, USA
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8
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Abstract
The importance of fetal magnetic resonance imaging (MRI) in the prenatal diagnosis of central nervous system (CNS) anomalies is rapidly increasing. Fetal MRI represents a third level examination usually performed, as early as 18-20 weeks of gestational age, when a second level (expert) neuro-ultrasonography (US) evaluation raises the suspicion of a CNS anomaly or when a genetic disorder is known. Compared to the US, MRI has the advantage to allow a better visualization and characterization of brain structures so to detect anomalies not visible in the US, thus resulting in relevant implications for parent counselling and pregnancy management. Moreover, the improvement of MRI technologies permits to obtain ultrafast sequences, which minimize the drawback of movement artifacts, and to perform advanced studies. This review aims at providing a practical guide for trainees and fellows who are approaching fetal MRI. In the first part, we provide information about indications, safety and protocols based on the state-of-the-art sequences, with a mention on the innovations related to the use of a 3T scanner. The second part is focused on the normal development of the human fetal brain related to its MR appearance, whose knowledge is essential to detect possible abnormalities. The last section briefly describes the most frequent abnormalities in the fetal brain and spine as depicted by MRI.
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Affiliation(s)
- Giulia Moltoni
- Neuroradiology Unit, NESMOS (Neurosciences, Mental Health and Sensory Organs) Department, S. Andrea Hospital, University Sapienza, Rome, Italy
| | - Giacomo Talenti
- Neuroradiology Unit, Department of Diagnostics and Pathology, Verona University Hospital, Verona, Italy
| | - Andrea Righini
- Neuroradiology Unit, Pediatric Radiology Department, Vittore Buzzi Children's Hospital, Milan, Italy
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9
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Magnetic resonance imaging of the brainstem in children, part 1: imaging techniques, embryology, anatomy and review of congenital conditions. Pediatr Radiol 2021; 51:172-188. [PMID: 33496830 DOI: 10.1007/s00247-020-04953-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 09/10/2020] [Accepted: 12/20/2020] [Indexed: 10/22/2022]
Abstract
Part 1 of this series of two articles describes conventional and advanced MRI techniques that are useful for evaluating brainstem pathologies. In addition, it provides a review of the embryology, normal progression of myelination, and clinically and radiologically salient imaging anatomy of the normal brainstem. Finally, it discusses congenital diseases of the brainstem with a focus on distinctive imaging features that allow for differentiating pathologies. Part 2 of this series of two articles includes discussion of neoplasms; infections; and vascular, demyelinating, toxic and metabolic, and miscellaneous disease processes affecting the brainstem. The ultimate goal of this pair of articles is to empower the radiologist to add clinical value in the care of pediatric patients with brainstem pathologies.
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Liu S, Trupiano MX, Simon J, Guo J, Anton ES. The essential role of primary cilia in cerebral cortical development and disorders. Curr Top Dev Biol 2021; 142:99-146. [PMID: 33706927 DOI: 10.1016/bs.ctdb.2020.11.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Primary cilium, first described in the 19th century in different cell types and organisms by Alexander Ecker, Albert Kolliker, Aleksandr Kowalevsky, Paul Langerhans, and Karl Zimmermann (Ecker, 1844; Kolliker, 1854; Kowalevsky, 1867; Langerhans, 1876; Zimmermann, 1898), play an essential modulatory role in diverse aspects of nervous system development and function. The primary cilium, sometimes referred to as the cell's 'antennae', can receive wide ranging inputs from cellular milieu, including morphogens, growth factors, neuromodulators, and neurotransmitters. Its unique structural and functional organization bequeaths it the capacity to hyper-concentrate signaling machinery in a restricted cellular domain approximately one-thousandth the volume of cell soma. Thus enabling it to act as a signaling hub that integrates diverse developmental and homestatic information from cellular milieu to regulate the development and function of neural cells. Dysfunction of primary cilia contributes to the pathophysiology of several brain malformations, intellectual disabilities, epilepsy, and psychiatric disorders. This review focuses on the most essential contributions of primary cilia to cerebral cortical development and function, in the context of neurodevelopmental disorders and malformations. It highlights the recent progress made in identifying the mechanisms underlying primary cilia's role in cortical progenitors, neurons and glia, in health and disease. A future challenge will be to translate these insights and advances into effective clinical treatments for ciliopathies.
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Affiliation(s)
- Siling Liu
- UNC Neuroscience Center and the Department of Cell and Molecular Physiology, University of North Carolina School of Medicine, Chapel Hill, NC, United States
| | - Mia X Trupiano
- UNC Neuroscience Center and the Department of Cell and Molecular Physiology, University of North Carolina School of Medicine, Chapel Hill, NC, United States
| | - Jeremy Simon
- UNC Neuroscience Center and the Department of Cell and Molecular Physiology, University of North Carolina School of Medicine, Chapel Hill, NC, United States
| | - Jiami Guo
- Hotchkiss Brain Institute, Alberta Children's Hospital Research Institute, and the Department of Cell Biology and Anatomy, University of Calgary, Calgary, AB, Canada
| | - E S Anton
- UNC Neuroscience Center and the Department of Cell and Molecular Physiology, University of North Carolina School of Medicine, Chapel Hill, NC, United States.
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Dovjak GO, Diogo MC, Brugger PC, Gruber GM, Weber M, Glatter S, Seidl R, Bettelheim D, Prayer D, Kasprian GJ. Quantitative fetal magnetic resonance imaging assessment of cystic posterior fossa malformations. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2020; 56:78-85. [PMID: 31595598 PMCID: PMC7384051 DOI: 10.1002/uog.21890] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 09/18/2019] [Accepted: 09/19/2019] [Indexed: 05/05/2023]
Abstract
OBJECTIVE Normal cognitive development usually requires a structurally intact and complete cerebellar vermis. The aim of this study was to evaluate whether quantification by fetal magnetic resonance imaging (MRI) of vermis- and brainstem-specific imaging markers improves the definition of cystic posterior fossa malformations (cPFM). METHODS Fetuses diagnosed with cPFM that had an available midsagittal plane on T2-weighted MRI were identified retrospectively and compared with gestational-age (GA) matched brain-normal controls. Fetuses with cPFM were assigned to three groups, according to standard criteria (vermian size and brainstem-vermis (BV) angle): normal vermian area and BV angle < 25° (Group 1); reduced vermian area and/or BV angle of 25-45° (Group 2); and reduced vermian area and BV angle > 45° (Group 3; Dandy-Walker malformation (DWM) group). The number of differentiable vermian lobules and the areas of the vermis, mesencephalon, pons and medulla oblongata were quantified, correlated with and controlled for GA, and compared between the study groups. RESULTS In total, 142 cases of cPFM were included, with a mean GA of 25.20 ± 5.11 weeks. Cases comprised Blake's pouch cyst (n = 46), arachnoid cyst (n = 12), inferior vermian hypoplasia (n = 5), megacisterna magna (n = 35) and classic DWM (n = 44). In the control group, 148 fetuses were included, with a mean GA of 25.26 ± 4.12 weeks. All quantified areas and the number of differentiable vermian lobules had a significant positive correlation with GA. The number of vermian lobules and the areas of all quantified regions, except for that of the medulla oblongata, differed significantly between the study groups (P ≤ 0.015 for all). The control group had the highest number of differentiable vermian lobules and the DWM group had the lowest (P < 0.01). CONCLUSIONS Prenatal MRI assessment of vermian lobules is a useful addition to standard neuroradiological and neurosonographic techniques. The quantification of vermian lobules using fetal MRI allows further differentiation of cPFM into subgroups and thereby improves the classification of hindbrain malformations. © 2019 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- G. O. Dovjak
- Department of Biomedical Imaging and Image‐Guided TherapyMedical University of ViennaViennaAustria
| | - M. C. Diogo
- Department of Biomedical Imaging and Image‐Guided TherapyMedical University of ViennaViennaAustria
| | - P. C. Brugger
- Department of Anatomy and BiomechanicsKarl Landsteiner University of Health SciencesKremsAustria
| | - G. M. Gruber
- Department of Anatomy and BiomechanicsKarl Landsteiner University of Health SciencesKremsAustria
| | - M. Weber
- Department of Biomedical Imaging and Image‐Guided TherapyMedical University of ViennaViennaAustria
| | - S. Glatter
- Department of Pediatrics and Adolescent MedicineMedical University of ViennaViennaAustria
| | - R. Seidl
- Department of Pediatrics and Adolescent MedicineMedical University of ViennaViennaAustria
| | - D. Bettelheim
- Department of Obstetrics and Feto‐Maternal MedicineMedical University of ViennaViennaAustria
| | - D. Prayer
- Department of Biomedical Imaging and Image‐Guided TherapyMedical University of ViennaViennaAustria
| | - G. J. Kasprian
- Department of Biomedical Imaging and Image‐Guided TherapyMedical University of ViennaViennaAustria
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Diffusion Weighted and Diffusion Tensor MRI in Pediatric Neuroimaging Including Connectomics: Principles and Applications. Semin Pediatr Neurol 2020; 33:100797. [PMID: 32331613 DOI: 10.1016/j.spen.2020.100797] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Diffusion weighted MRI (DWI) including diffusion tensor imaging (DTI) are unique imaging techniques that render qualitative and quantitative information of the central nervous system white matter (WM) ultrastructure. It uses the Brownian movement of water molecules to probe tissue microstructure. It is a noninvasive method, with superb sensitivity to the differential mobility of water molecules within various components of the brain without the necessity to inject contrast agents. By sampling the 3 dimensional shape, direction and magnitude of the water diffusion, DWI/DTI generates unique tissue contrasts that can be used to study the axonal WM organization of the central nervous system. Its application allows to study the normal and anomalous brain development including connectivity, as well as a multitude of WM diseases. This article discusses/summarizes the principles of DWI/DTI and its applications in pediatric neuroscience research.
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14
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Meoded A, Huisman TAGM. Diffusion Tensor Imaging of Brain Malformations: Exploring the Internal Architecture. Neuroimaging Clin N Am 2019; 29:423-434. [PMID: 31256863 DOI: 10.1016/j.nic.2019.03.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Diffusion tensor imaging (DTI) is an advanced MR imaging technique that provides noninvasive qualitative and quantitative information about the white matter microarchitecture. By measuring the three-dimensional directional characteristics of water molecule diffusion/mobility, DTI generates unique tissue contrasts that are used to study the axonal organization of the central nervous system. Its applications include quantitative evaluation of the brain connectivity, development, and white matter diseases. This article reviews DTI and fiber tractography findings in several brain malformations and highlights the added value of DTI and fiber tractography compared with conventional MR imaging.
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Affiliation(s)
- Avner Meoded
- Johns Hopkins All Children's Hospital, 501 6th Avenue South, St Petersburg, FL 33701, USA.
| | - Thierry A G M Huisman
- Edward B. Singleton Department of Radiology, Texas Children's Hospital, 6701 Fannin Street, Suite 470, Houston, TX 77030, USA
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15
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Pontine tegmental cap dysplasia with a duplicated internal auditory canal. Radiol Case Rep 2019; 14:825-828. [PMID: 31049119 PMCID: PMC6484283 DOI: 10.1016/j.radcr.2019.04.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 04/07/2019] [Accepted: 04/07/2019] [Indexed: 11/25/2022] Open
Abstract
Pontine tegmental cap dysplasia (PTCD) is a rare neurological syndrome that results in a hypoplastic ventral pons, tegmental cap at the dorsal pons, and cranial nerve dysfunction. The most common symptoms are hearing loss and speech problems. We present a case of a 9-month-old male who presented with developmental delay and hypotonia. Magnetic resonance imaging revealed ectopic dorsal transverse pontine fibers and a cap-like protrusion of the dorsal pons. Diffusion tensor imaging showed that the ventral pontine fibers were absent. The cause of PTCD is undiscovered, but proposed hypotheses include dysfunction in axonal guidance, neuronal migration, and ciliary protein function. PTCD is a rare neurological disorder, but the diagnosis can be suggested with MRI using diffusion tensor imaging as an aid.
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Herrera DA, Ruge NO, Florez MM, Vargas SA, Ochoa-Escudero M, Castillo M. Neuroimaging Findings in Moebius Sequence. AJNR Am J Neuroradiol 2019; 40:862-865. [PMID: 30948378 DOI: 10.3174/ajnr.a6028] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 03/12/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Moebius sequence comprises a spectrum of brain congenital malformations predominantly affecting the function of multiple cranial nerves. Reported neuroimaging findings are heterogeneous and based on case reports or small case series. Our goal was to describe the neuroimaging findings of Moebius sequence in a large population of patients scanned with MR imaging. MATERIALS AND METHODS An observational cross-sectional study was performed to assess brain MR imaging findings in 38 patients with Moebius syndrome studied between 2013 and 2016. RESULTS Retrospective analysis of MR imaging studies showed flattening of the floor of the fourth ventricle floor secondary to a bilateral absent facial colliculus in 38 patients (100%) and unilateral absence in 1. A hypoplastic pons was found in 23 patients (60.5%). Mesencephalic malformations consisted of tectal beaking in 15 patients (39.5%) and increased anteroposterior midbrain diameter with a shallow interpeduncular cistern in 12 (31.6%). Infratentorial arachnoid cysts were found in 5 patients (13.2%), and cerebellar vermis hypoplasia, in 2 (5.3%). Supratentorial findings included the following: thalamic fusion (26.3%), periventricular nodular heterotopias (26.3%), ventriculomegaly (26.3%), callosal abnormalities (23.7%), and hippocampal malrotations (23.7%). CONCLUSIONS Findings seen in this large patient cohort agreed with previously published reports. Flattening of the fourth ventricle floor secondary to a bilaterally absent facial colliculus was the most frequent MR imaging finding. The presence of other brain stem and cerebellar malformations as well as supratentorial abnormalities may help explain clinical symptoms and achieve a correct diagnosis.
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Affiliation(s)
- D A Herrera
- From the Department of Radiology (D.A.H., M.M.F., S.A.V.)
| | - N O Ruge
- Grupo de Neurociencias (N.O.R.), Universidad de Antioquia, Medellín, Colombia
| | - M M Florez
- From the Department of Radiology (D.A.H., M.M.F., S.A.V.)
| | - S A Vargas
- From the Department of Radiology (D.A.H., M.M.F., S.A.V.)
| | - M Ochoa-Escudero
- Department of Radiology (M.O.-E.), Hospital Pablo Tobón Uribe, Medellín, Colombia
| | - M Castillo
- Department of Radiology (M.C.), University of North Carolina, Chapel Hill, North Carolina
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17
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Counsell SJ, Arichi T, Arulkumaran S, Rutherford MA. Fetal and neonatal neuroimaging. HANDBOOK OF CLINICAL NEUROLOGY 2019; 162:67-103. [PMID: 31324329 DOI: 10.1016/b978-0-444-64029-1.00004-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Magnetic resonance imaging (MRI) can provide detail of the soft tissues of the fetal and neonatal brain that cannot be obtained by any other imaging modality. Conventional T1 and T2 weighted sequences provide anatomic detail of the normally developing brain and can demonstrate lesions, including those associated with preterm birth, hypoxic ischemic encephalopathy, perinatal arterial stroke, infections, and congenital malformations. Specialized imaging techniques can be used to assess cerebral vasculature (magnetic resonance angiography and venography), cerebral metabolism (magnetic resonance spectroscopy), cerebral perfusion (arterial spin labeling), and function (functional MRI). A wealth of quantitative tools, most of which were originally developed for the adult brain, can be applied to study the developing brain in utero and postnatally including measures of tissue microstructure obtained from diffusion MRI, morphometric studies to measure whole brain and regional tissue volumes, and automated approaches to study cortical folding. In this chapter, we aim to describe different imaging approaches for the fetal and neonatal brain, and to discuss their use in a range of clinical applications.
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Affiliation(s)
- Serena J Counsell
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom.
| | - Tomoki Arichi
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Sophie Arulkumaran
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Mary A Rutherford
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
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18
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Brotelande C, Leboucq N, Akkari M, Roujeau T, Di Maio M, Milési C, Mondain M, Raybaud C, Cambonie G. Isolated neonatal bilateral vocal cord paralysis revealing a unilateral medullary defect: a case report. BMC Pediatr 2018; 18:351. [PMID: 30413155 PMCID: PMC6234783 DOI: 10.1186/s12887-018-1329-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 10/29/2018] [Indexed: 12/20/2022] Open
Abstract
Background Congenital bilateral vocal cord paralysis is a rare occurrence. Approximately half the cases are associated with a major comorbidity, usually neurological, neuromuscular or malformative. Case presentation In a male newborn, respiratory distress syndrome and stridor were observed immediately following birth. The cause was bilateral vocal cord paralysis in the adducted position. Neuroradiological investigation revealed a unilateral discontinuity between the upper pons and the right medulla oblongata. Hypoplasia of the right posterior hemiarches of C1-C2 and the right exo-occipital bone was observed, as was a small clivus. MR angiography showed the absence of the distal right vertebral artery, with hypoplasia and parietal irregularities of the proximal segments. Respiratory autonomy was not obtained despite endoscopic laser cordotomy, corticosteroid therapy and nasal continuous positive airway pressure. The infant died at the age of 4 weeks after treatment was limited to comfort care. Conclusions A medullary lesion is an exceptional cause of congenital bilateral vocal cord paralysis. The strictly unilateral neurological and vascular defect and the absence of associated intracranial or extracranial malformation make this clinical case unique and suggest a disruptive mechanism. This case also highlights the help provided by advanced neuroimaging techniques, i.e. fibre tracking using diffusion tensor imaging, in the decision-making process.
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Affiliation(s)
- Camille Brotelande
- Department of Neonatology and Paediatric Intensive Care Unit, Arnaud de Villeneuve Hospital, Montpellier University Hospital, 371 Avenue du Doyen Gaston Giraud, 34295, Montpellier, Cedex 5, France
| | - Nicolas Leboucq
- Department of Paediatric Radiology, Arnaud de Villeneuve Hospital, Montpellier University Hospital, Montpellier, France
| | - Mohamed Akkari
- Department of Otorhinolaryngology, Gui-de-Chauliac Hospital, Montpellier University Hospital, Montpellier, France
| | - Thomas Roujeau
- Department of Neurosurgery, Gui-de-Chauliac Hospital, Montpellier University Hospital, Montpellier, France
| | - Massimo Di Maio
- Neonatal Intensive Care Unit, Carémeau Hospital, Nîmes University Hospital, Nîmes, France
| | - Christophe Milési
- Department of Neonatology and Paediatric Intensive Care Unit, Arnaud de Villeneuve Hospital, Montpellier University Hospital, 371 Avenue du Doyen Gaston Giraud, 34295, Montpellier, Cedex 5, France
| | - Michel Mondain
- Department of Otorhinolaryngology, Gui-de-Chauliac Hospital, Montpellier University Hospital, Montpellier, France
| | - Charles Raybaud
- Division of Neuroradiology, Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G1X8, Canada
| | - Gilles Cambonie
- Department of Neonatology and Paediatric Intensive Care Unit, Arnaud de Villeneuve Hospital, Montpellier University Hospital, 371 Avenue du Doyen Gaston Giraud, 34295, Montpellier, Cedex 5, France.
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19
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Haratz KK, Lerman-Sagie T. Prenatal diagnosis of brainstem anomalies. Eur J Paediatr Neurol 2018; 22:1016-1026. [PMID: 30448280 DOI: 10.1016/j.ejpn.2018.06.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 06/27/2018] [Accepted: 06/28/2018] [Indexed: 10/28/2022]
Abstract
Prenatal diagnosis of brainstem anomalies is important due to the usually associated neurodevelopmental impairment and genetic implications. The extreme developmental changes that the brainstem and cerebellum undergo during fetal life pose a challenge for the characterization and definition of the different malformations. The present review aims to demonstrate the normal development of the fetal brainstem and to present the main features required for diagnosis of its anomalies according to available data in the medical literature.
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Affiliation(s)
- Karina Krajden Haratz
- Fetal Neurology Clinic, Ultrasound in Ob-Gyn Unit, Wolfson Medical Center, Holon, Israel; Lis Maternity Hospital, Tel Aviv Medical Center, Tel Aviv, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Tally Lerman-Sagie
- Fetal Neurology Clinic, Ultrasound in Ob-Gyn Unit, Wolfson Medical Center, Holon, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Pediatric Neurology Unit, Wolfson Medical Center, Holon, Israel
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20
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Cerebellar Ataxia in Children: A Clinical and MRI Approach to the Differential Diagnosis. Top Magn Reson Imaging 2018; 27:275-302. [PMID: 30086112 DOI: 10.1097/rmr.0000000000000175] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
: The cerebellum has long been recognized as a fundamental structure in motor coordination. Structural cerebellar abnormalities and diseases involving the cerebellum are relatively common in children. The not always specific clinical presentation of ataxia, incoordination, and balance impairment can often be a challenge to attain a precise diagnosis. Continuous advances in genetic research and moreover the constant development in neuroimaging modalities, particularly in the field of magnetic resonance imaging, have promoted a better understanding of cerebellar diseases and led to several modifications in their classification in recent years. Thorough clinical and neuroimaging investigation is recommended for proper diagnosis. This review outlines an update of causes of cerebellar disorders that present clinically with ataxia in the pediatric population. These conditions were classified in 2 major groups, namely genetic malformations and acquired or disruptive disorders recognizable by neuroimaging and subsequently according to their features during the prenatal and postnatal periods.
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21
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Arrigoni F, Romaniello R, Peruzzo D, Poretti A, Bassi MT, Pierpaoli C, Valente EM, Nuovo S, Boltshauser E, Huisman TAGM, Triulzi F, Borgatti R. The spectrum of brainstem malformations associated to mutations of the tubulin genes family: MRI and DTI analysis. Eur Radiol 2018; 29:770-782. [DOI: 10.1007/s00330-018-5610-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 05/15/2018] [Accepted: 06/15/2018] [Indexed: 02/08/2023]
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22
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Lauda A, Bruehschwein A, Ficek J, Schmidt MJ, Klima A, Meyer-Lindenberg A, Fischer A. Caudal Fossa Ratio in Normal Dogs and Eurasier Dogs with VLDLR-Associated Genetic Cerebellar Hypoplasia. Front Vet Sci 2018; 4:241. [PMID: 29404343 PMCID: PMC5786823 DOI: 10.3389/fvets.2017.00241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 12/20/2017] [Indexed: 12/26/2022] Open
Abstract
Cerebellar and hindbrain malformations, such as cerebellar hypoplasia (CH), vermis hypoplasia, and Dandy–Walker malformation, occur in dogs as well as in humans. Neuroimaging is essential for a precise description of these malformations and defining translational animal models. Neuroimaging is increasingly performed in puppies, but there is a lack of data on developmental changes in the caudal fossa, which can impair assessment of caudal fossa size in this age group. The purpose of this study was to validate caudal fossa ratio (CFR) in dogs and to explore CFR in Eurasier dogs with genetic CH. CFR was calculated from midsagittal brain images of 130 dogs as caudal fossa area/total cranial cavity area. In addition, the volume of the caudal fossa was measured in 64 randomly selected dogs from this group. Repeated measurements were used to investigate inter- and intra-rater variability and influence of imaging modality. Furthermore, the influence of age, weight, and breed was explored. The CFR was a reliable parameter with negligible influence from the examiners, imaging modality, and weight of the dog. The midsagittal area of the caudal fossa and the volume of the caudal fossa correlated closely with each other. In this study, we observed a smaller CFR in puppies. The CFR in adult dogs lies within 0.255 and 0.330, while CFR is smaller in puppies up to 4 months of age. Besides age, there was also an effect of breed, which should be explored in larger data sets. Measurements of CFR in Eurasier dogs with genetic CH caused by a mutation in the very-low-density-lipoprotein-receptor gene revealed the presence of two variants, one with an enlarged caudal fossa and one with a normal to small caudal fossa. This observation indicates that there is phenotypic heterogeneity and interaction between the developing cerebellum and the surrounding mesenchyme in this animal model.
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Affiliation(s)
- Alexander Lauda
- Centre for Clinical Veterinary Medicine, Clinic of Small Animal Medicine, LMU Munich, Munich, Germany
| | - Andreas Bruehschwein
- Centre for Clinical Veterinary Medicine, Clinic of Small Animal Surgery and Reproduction, LMU Munich, Munich, Germany
| | - Joanna Ficek
- Statistical Consulting Unit StaBLab, Department of Statistics, LMU Munich, Munich, Germany
| | - Martin J Schmidt
- Department of Veterinary Clinical Science, Small Animal Clinic, Justus-Liebig-University, Giessen, Germany
| | - André Klima
- Statistical Consulting Unit StaBLab, Department of Statistics, LMU Munich, Munich, Germany
| | - Andrea Meyer-Lindenberg
- Centre for Clinical Veterinary Medicine, Clinic of Small Animal Surgery and Reproduction, LMU Munich, Munich, Germany
| | - Andrea Fischer
- Centre for Clinical Veterinary Medicine, Clinic of Small Animal Medicine, LMU Munich, Munich, Germany
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23
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Severino M, Righini A, Tortora D, Pinelli L, Parazzini C, Morana G, Accorsi P, Capra V, Paladini D, Rossi A. MR Imaging Diagnosis of Diencephalic-Mesencephalic Junction Dysplasia in Fetuses with Developmental Ventriculomegaly. AJNR Am J Neuroradiol 2017; 38:1643-1646. [PMID: 28596193 DOI: 10.3174/ajnr.a5245] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 03/29/2017] [Indexed: 11/07/2022]
Abstract
Diencephalic-mesencephalic junction dysplasia is a rare malformation characterized by a poorly defined junction between the diencephalon and the mesencephalon, associated with a characteristic butterfly-like contour of the midbrain (butterfly sign). This condition may be variably associated with other brain malformations, including callosal abnormalities and supratentorial ventricular dilation, and is a potential cause of developmental hydrocephalus. Here, we have reported 13 fetuses with second-trimester obstructive ventriculomegaly and MR features of diencephalic-mesencephalic junction dysplasia, correlating the fetal imaging with available pathology and/or postnatal data. The butterfly sign can be clearly detected on axial images on fetal MR imaging, thus allowing for the prenatal diagnosis of diencephalic-mesencephalic junction dysplasia, with possible implications for the surgical management of hydrocephalus and parental counseling.
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Affiliation(s)
- M Severino
- From the Neuroradiology Unit (M.S., D.T., G.M., A. Rossi)
| | - A Righini
- Radiology and Neuroradiology Department (A. Righini, C.P.), Ospedale dei Bambini V Buzzi, Milano, Italy
| | - D Tortora
- From the Neuroradiology Unit (M.S., D.T., G.M., A. Rossi)
| | | | - C Parazzini
- Radiology and Neuroradiology Department (A. Righini, C.P.), Ospedale dei Bambini V Buzzi, Milano, Italy
| | - G Morana
- From the Neuroradiology Unit (M.S., D.T., G.M., A. Rossi)
| | - P Accorsi
- Neuropsychiatry Units (P.A.), Azienda Ospedaliera Spedali Civili di Brescia, Brescia, Italy
| | - V Capra
- Genetic Unit, Department of Neurosurgery (V.C.)
| | - D Paladini
- Fetal Medicine and Surgery Unit (D.P.), Istituto Giannina Gaslini, Genoa, Italy
| | - A Rossi
- From the Neuroradiology Unit (M.S., D.T., G.M., A. Rossi)
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24
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Abstract
The frequency and importance of the evaluation of the posterior fossa have increased significantly over the past 20 years owing to advances in neuroimaging. Conventional and advanced neuroimaging techniques allow detailed evaluation of the complex anatomic structures within the posterior fossa. A wide spectrum of cerebellar and brainstem malformations has been shown. Familiarity with the spectrum of cerebellar and brainstem malformations and their well-defined diagnostic criteria is crucial for optimal therapy, an accurate prognosis, and correct genetic counseling. This article discusses cerebellar and brainstem malformations, with emphasis on neuroimaging findings (including diagnostic criteria), neurologic presentation, systemic involvement, prognosis, and recurrence.
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25
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Abstract
We aim to review the magnetic resonance imaging appearance of malformations of midbrain and hindbrain. These can be classified as predominantly cerebellar malformations, combined cerebellar and brain stem malformations, and predominantly brain stem malformations. The diagnostic criteria for the majority of these morphological malformations are based on neuroimaging findings. The predominantly cerebellar malformations include predominantly vermian hypoplasia seen in Dandy-Walker malformation and rhombencephalosynapsis, global cerebellar hypoplasia reported in lissencephaly and microlissencephaly, and unilateral cerebellar hypoplasia seen in PHACES, vanishing cerebellum, and cerebellar cleft. Cerebellar dysplasias are seen in Chudley-McCullough syndrome, associated with LAMA1 mutations and GPR56 mutations; Lhermitte-Duclos disease; and focal cerebellar dysplasias. Cerebellar hyperplasias are seen in megalencephaly-related syndromes and hemimegalencephaly with ipsilateral cerebellomegaly. Cerebellar and brain stem malformations include tubulinopathies, Joubert syndrome, cobblestone malformations, pontocerebellar hypoplasias, and congenital disorders of glycosylation type Ia. Predominantly brain stem malformations include congenital innervation dysgenesis syndrome, pontine tegmental cap dysplasia, diencephalic-mesencephalic junction dysplasia, disconnection syndrome, and pontine clefts.
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26
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27
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Micalizzi A, Poretti A, Romani M, Ginevrino M, Mazza T, Aiello C, Zanni G, Baumgartner B, Borgatti R, Brockmann K, Camacho A, Cantalupo G, Haeusler M, Hikel C, Klein A, Mandrile G, Mercuri E, Rating D, Romaniello R, Santorelli FM, Schimmel M, Spaccini L, Teber S, von Moers A, Wente S, Ziegler A, Zonta A, Bertini E, Boltshauser E, Valente EM. Clinical, neuroradiological and molecular characterization of cerebellar dysplasia with cysts (Poretti-Boltshauser syndrome). Eur J Hum Genet 2016; 24:1262-7. [PMID: 26932191 DOI: 10.1038/ejhg.2016.19] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 01/14/2016] [Accepted: 02/01/2016] [Indexed: 12/11/2022] Open
Abstract
Cerebellar dysplasia with cysts and abnormal shape of the fourth ventricle, in the absence of significant supratentorial anomalies and of muscular involvement, defines recessively inherited Poretti-Boltshauser syndrome (PBS). Clinical features comprise non-progressive cerebellar ataxia, intellectual disability of variable degree, language impairment, ocular motor apraxia and frequent occurrence of myopia or retinopathy. Recently, loss-of-function variants in the LAMA1 gene were identified in six probands with PBS. Here we report the detailed clinical, neuroimaging and genetic characterization of 18 PBS patients from 15 unrelated families. Biallelic LAMA1 variants were identified in 14 families (93%). The only non-mutated proband presented atypical clinical and neuroimaging features, challenging the diagnosis of PBS. Sixteen distinct variants were identified, which were all novel. In particular, the frameshift variant c.[2935delA] recurred in six unrelated families on a shared haplotype, suggesting a founder effect. No LAMA1 variants could be detected in 27 probands with different cerebellar dysplasias or non-progressive cerebellar ataxia, confirming the strong correlate between LAMA1 variants and PBS.
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Affiliation(s)
- Alessia Micalizzi
- CSS-Mendel Institute, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.,Department of Biological and Environmental Sciences, University of Messina, Messina, Italy
| | - Andrea Poretti
- Department of Pediatric Neurology, University Children's Hospital, Zurich, Switzerland.,Section of Pediatric Neuroradiology, Division of Pediatric Radiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Marta Romani
- CSS-Mendel Institute, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Monia Ginevrino
- CSS-Mendel Institute, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Tommaso Mazza
- CSS-Mendel Institute, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Chiara Aiello
- Laboratory of Molecular Medicine, Unit of Neuromuscular and Neurodegenerative Disorders, Department of Neurosciences, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Ginevra Zanni
- Laboratory of Molecular Medicine, Unit of Neuromuscular and Neurodegenerative Disorders, Department of Neurosciences, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | | | - Renato Borgatti
- Neuropsychiatry and Neurorehabilitation Unit, Scientific Institute IRCCS Eugenio Medea, Lecco, Italy
| | - Knut Brockmann
- Interdisciplinary Pediatric Center for Children with Developmental Disabilities and Severe Chronic Disorders, Department of Pediatrics and Adolescent Medicine, University of Goettingen, Goettingen, Germany
| | - Ana Camacho
- Section of Pediatric Neurology, Hospital Universitario 12 de Octubre, Department of Medicine, Universidad Complutense, Madrid, Spain
| | - Gaetano Cantalupo
- Child Neuropsychiatry, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - Martin Haeusler
- Department of Pediatrics, Division of Neuropediatrics and Social Pediatrics, University Hospital, RWTH Aachen, Aachen, Germany
| | - Christiane Hikel
- Social Pediatic Centrum (SPZ), St Vinzenz Hospital, Dinslaken, Germany
| | - Andrea Klein
- Department of Pediatric Neurology, University Children's Hospital, Zurich, Switzerland
| | - Giorgia Mandrile
- SCDU Medical Genetics, Hospital Città della Salute e della Scienza di Torino, Turin, Italy
| | | | - Dietz Rating
- Pediatrics, St Marien and St Anna Hospital, Ludwigshafen, Germany
| | - Romina Romaniello
- Neuropsychiatry and Neurorehabilitation Unit, Scientific Institute IRCCS Eugenio Medea, Lecco, Italy
| | | | - Mareike Schimmel
- Division of Pediatric Neurology, Children's Hospital, Klinikum Augsburg, Augsburg, Germany
| | - Luigina Spaccini
- Clinical Genetic Unit, Department of Women, Mother and Neonates, 'Vittore Buzzi' Children Hospital, Istituti Clinici di Perfezionamento, Milan, Italy
| | - Serap Teber
- Department of Pediatric Neurology, Ankara Pediatrics, Hematology-Oncology Training and Research Hospital, Ankara, Turkey
| | - Arpad von Moers
- Department of Pediatrics, DRK Kliniken Berlin Westend, Berlin, Germany
| | - Sarah Wente
- Interdisciplinary Pediatric Center for Children with Developmental Disabilities and Severe Chronic Disorders, Department of Pediatrics and Adolescent Medicine, University of Goettingen, Goettingen, Germany
| | - Andreas Ziegler
- Division of Pediatric Neurology, University Children's Hospital Heidelberg, Germany
| | - Andrea Zonta
- SCDU Medical Genetics, Hospital Città della Salute e della Scienza di Torino, Turin, Italy
| | - Enrico Bertini
- Laboratory of Molecular Medicine, Unit of Neuromuscular and Neurodegenerative Disorders, Department of Neurosciences, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Eugen Boltshauser
- Department of Pediatric Neurology, University Children's Hospital, Zurich, Switzerland
| | - Enza Maria Valente
- CSS-Mendel Institute, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.,Section of Neurosciences, Department of Medicine and Surgery, University of Salerno, Salerno, Italy
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28
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Expanding the spectrum of congenital anomalies of the diencephalic–mesencephalic junction. Neuroradiology 2015; 58:33-44. [DOI: 10.1007/s00234-015-1601-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 09/24/2015] [Indexed: 02/07/2023]
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