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Verschuur AS, King R, Tax CMW, Boomsma MF, van Wezel-Meijler G, Leemans A, Leijser LM. Methodological considerations on diffusion MRI tractography in infants aged 0-2 years: a scoping review. Pediatr Res 2024:10.1038/s41390-024-03463-2. [PMID: 39143201 DOI: 10.1038/s41390-024-03463-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 07/20/2024] [Accepted: 07/24/2024] [Indexed: 08/16/2024]
Abstract
Diffusion MRI (dMRI) enables studying the complex architectural organization of the brain's white matter (WM) through virtual reconstruction of WM fiber tracts (tractography). Despite the anticipated clinical importance of applying tractography to study structural connectivity and tract development during the critical period of rapid infant brain maturation, detailed descriptions on how to approach tractography in young infants are limited. Over the past two decades, tractography from infant dMRI has mainly been applied in research settings and focused on diffusion tensor imaging (DTI). Only few studies used techniques superior to DTI in terms of disentangling information on the brain's organizational complexity, including crossing fibers. While more advanced techniques may enhance our understanding of the intricate processes of normal and abnormal brain development and extensive knowledge has been gained from application on adult scans, their applicability in infants has remained underexplored. This may partially be due to the higher technical requirements versus the need to limit scan time in young infants. We review various previously described methodological practices for tractography in the infant brain (0-2 years-of-age) and provide recommendations to optimize advanced tractography approaches to enable more accurate reconstructions of the brain WM's complexity. IMPACT: Diffusion tensor imaging is the technique most frequently used for fiber tracking in the developing infant brain but is limited in capability to disentangle the complex white matter organization. Advanced tractography techniques allow for reconstruction of crossing fiber bundles to better reflect the brain's complex organization. Yet, they pose practical and technical challenges in the fast developing young infant's brain. Methods on how to approach advanced tractography in the young infant's brain have hardly been described. Based on a literature review, recommendations are provided to optimize tractography for the developing infant brain, aiming to advance early diagnosis and neuroprotective strategies.
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Affiliation(s)
- Anouk S Verschuur
- Department of Radiology, Isala Hospital Zwolle, Zwolle, The Netherlands.
- Department of Pediatrics, Section of Newborn Critical Care, University of Calgary, Calgary, Canada.
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Regan King
- Department of Pediatrics, Section of Newborn Critical Care, University of Calgary, Calgary, Canada
| | - Chantal M W Tax
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
- CUBRIC, School of Physics and Astronomy, Cardiff University, Cardiff, United Kingdom
| | - Martijn F Boomsma
- Department of Radiology, Isala Hospital Zwolle, Zwolle, The Netherlands
- Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Gerda van Wezel-Meijler
- Department of Neonatology, Isala Women and Children's Hospital Zwolle, Zwolle, The Netherlands
| | - Alexander Leemans
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Lara M Leijser
- Department of Pediatrics, Section of Newborn Critical Care, University of Calgary, Calgary, Canada
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Orman G, Kralik SF, Battini R, Buchignani B, Desai NK, Goetti R, Meoded A, Mitter C, Wallacher-Scholz B, Boltshauser E, Huisman TAGM. Neuroimaging Features of Ectopic Cerebellar Tissue: A Case Series Study of a Rare Entity. AJNR Am J Neuroradiol 2021; 42:1167-1173. [PMID: 34255731 DOI: 10.3174/ajnr.a7105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 01/05/2021] [Indexed: 11/07/2022]
Abstract
Ectopic cerebellar tissue is a rare entity likely secondary to multiple, interacting, developmental errors during embryogenesis. Multiple sites of ectopic cerebellar tissue have been reported, including extracranial locations; however, an intracranial location is most common. We report on the MR imaging findings of a multi-institutional series of 7 ectopic cerebellar tissue cases (2 males, 4 females, 1 fetal) ranging from 22 weeks 5 days' gestational age to 18 years of age. All cases of ectopic cerebellar tissue were diagnosed incidentally, while imaging was performed for other causes. Ectopic cerebellar tissue was infratentorial in 6/7 patients and supratentorial in 1/7 patients. All infratentorial ectopic cerebellar tissue was connected with the brain stem or cerebellum. MR imaging signal intensity was identical to the cerebellar gray and white matter signal intensity on all MR imaging sequences in all cases. Ectopic cerebellar tissue should be considered in the differential diagnoses of extra-axial masses with signal characteristics similar to those of the cerebellum. Surgical biopsy or resection is rarely necessary, and in most cases, MR imaging is diagnostic.
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Affiliation(s)
- G Orman
- From the Edward B. Singleton Department of Radiology (G.O., S.F.K., N.K.D., A.M., T.A.G.M.H.), Texas Children's Hospital, Houston, Texas
| | - S F Kralik
- From the Edward B. Singleton Department of Radiology (G.O., S.F.K., N.K.D., A.M., T.A.G.M.H.), Texas Children's Hospital, Houston, Texas
| | - R Battini
- Department of Developmental Neuroscience (R.B.), Istituto di Ricovero e Cura a Carattere Scientifico Fondazione Stella Maris, Pisa, Italy
- Department of Clinical and Experimental Medicine (R.B., B.B.), University of Pisa, Pisa, Italy
| | - B Buchignani
- Department of Clinical and Experimental Medicine (R.B., B.B.), University of Pisa, Pisa, Italy
| | - N K Desai
- From the Edward B. Singleton Department of Radiology (G.O., S.F.K., N.K.D., A.M., T.A.G.M.H.), Texas Children's Hospital, Houston, Texas
| | - R Goetti
- Department of Medical Imaging (R.G.), The Children's Hospital at Westmead, The University of Sydney, Sydney, Australia
| | - A Meoded
- From the Edward B. Singleton Department of Radiology (G.O., S.F.K., N.K.D., A.M., T.A.G.M.H.), Texas Children's Hospital, Houston, Texas
| | - C Mitter
- Department of Biomedical Imaging and Image-Guided Therapy (C.M.), Medical University of Vienna, Vienna, Austria
| | - B Wallacher-Scholz
- Department of Pediatric Neurology and Developmental Medicine and LMU Center for Children with Medical Complexity (B.W.-S.), Dr. von Hauner Children's Hospital, LMU University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
| | - E Boltshauser
- Department of Pediatric Neurology (E.B.), University Children's Hospital Zürich, Zurich, Switzerland
| | - T A G M Huisman
- From the Edward B. Singleton Department of Radiology (G.O., S.F.K., N.K.D., A.M., T.A.G.M.H.), Texas Children's Hospital, Houston, Texas
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Hamrick FA, Karsy M, Bruggers CS, Putnam AR, Hedlund GL, Cheshier SH. Developmentally anomalous cerebellar encephalocele arising within the cerebellopontine angle and extending into the adjacent skull base in a pediatric patient. Childs Nerv Syst 2021; 37:2943-2947. [PMID: 33566142 PMCID: PMC8423691 DOI: 10.1007/s00381-020-05020-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 12/17/2020] [Indexed: 11/30/2022]
Abstract
Lesions of the cerebellopontine angle (CPA) in young children are rare, with the most common being arachnoid cysts and epidermoid inclusion cysts. The authors report a case of an encephalocele containing heterotopic cerebellar tissue arising from the right middle cerebellar peduncle and filling the right internal acoustic canal in a 2-year-old female patient. Her initial presentation included a focal left 6th nerve palsy. Magnetic resonance imaging was suggestive of a high-grade tumor of the right CPA. The lesion was removed via a retrosigmoid approach, and histopathologic analysis revealed heterotopic atrophic cerebellar tissue. This report is the first description of a heterotopic cerebellar encephalocele within the CPA and temporal skull base of a pediatric patient.
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Affiliation(s)
- Forrest A. Hamrick
- Division of Pediatric Neurosurgery, Department of Neurosurgery, University of Utah, 100 N. Mario Capecchi Drive, Salt Lake City, UT 84113 USA
| | - Michael Karsy
- Division of Pediatric Neurosurgery, Department of Neurosurgery, University of Utah, 100 N. Mario Capecchi Drive, Salt Lake City, UT 84113 USA
| | - Carol S. Bruggers
- Primary Children’s Hospital, University of Utah, Salt Lake City, UT USA ,Division of Neuro-Oncology, Department of Pediatrics, University of Utah, Salt Lake City, UT USA
| | - Angelica R. Putnam
- Primary Children’s Hospital, University of Utah, Salt Lake City, UT USA ,Department of Pathology, University of Utah, Salt Lake City, UT USA
| | - Gary L. Hedlund
- Primary Children’s Hospital, University of Utah, Salt Lake City, UT USA ,Department of Medical Imaging, Primary Children’s Hospital, University of Utah, Salt Lake City, UT USA
| | - Samuel H. Cheshier
- Division of Pediatric Neurosurgery, Department of Neurosurgery, University of Utah, 100 N. Mario Capecchi Drive, Salt Lake City, UT 84113 USA ,Primary Children’s Hospital, University of Utah, Salt Lake City, UT USA
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Gupta M, Duddleston PJ, Sagi V, Powers M, Sang U H. Ectopic Cerebellar Tissue in the Occipital Bone: A Case Report. J Neurol Surg Rep 2020; 81:e42-e45. [PMID: 32782896 PMCID: PMC7414970 DOI: 10.1055/s-0040-1712917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 09/28/2019] [Indexed: 10/28/2022] Open
Abstract
Ectopic cerebellar tissue has only been described in isolated case reports, with only two reported cases in adult patients. We report the case of a 63-year-old woman with progressive, medically refractory headaches. A scan showed an intraosseous lesion of the midline occipital bone. Surgical resection of the soft tissue lesion was undertaken. Her headaches ceased postoperatively. Histopathological analysis revealed cerebellar cortical tissue with a surrounding meningothelial cell layer, characteristic of cerebellar ectopia. This is the second reported case of an intraosseous location of this lesion, and only the third case described in an adult patient. Our findings illustrate a rare cause of headaches and support the therapeutic roles of surgical treatment for this extremely rare condition.
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Affiliation(s)
- Mihir Gupta
- Department of Neurosurgery, University of California San Diego, San Diego, California, United States
| | - Pate J Duddleston
- Department of Neurosurgery, School of Medicine, Mercer University, Macon, Georgia, United States
| | - Varun Sagi
- Department of Neurosurgery, School of Medicine, University of Minnesota, Minneapolis, Minnesota, United States
| | - Martin Powers
- Division of Neuropathology, Department of Neuropathology, University of California San Diego, San Diego, California, United States
| | - Hoi Sang U
- Department of Neurosurgery, University of California San Diego, San Diego, California, United States
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De Benedictis A, Rossi-Espagnet MC, Diomedi-Camassei F, Rossi S, Fontana E, Randi F, Ponzo V, Nucci C, Esposito G, Paternò G, Brunetti C, Savioli A, Carai A, Marras CE. Intraventricular Ectopic Cerebellum. World Neurosurg 2020; 137:158-163. [PMID: 31996339 DOI: 10.1016/j.wneu.2020.01.127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 01/13/2020] [Accepted: 01/16/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Cerebellar ectopy is a rare finding, with few cases previously reported. Intraventricular localized cerebellar ectopy was described in only 1 case within the fourth ventricle. CASE DESCRIPTION A 9-year-old girl suffered for 2 years from bilateral frontoparietal headaches, sometimes accompanied by vomiting and photophobia. Magnetic resonance imaging demonstrated an oval-shaped lesion within the left lateral ventricle, characterized by well-defined margins without a clear cleavage plane from the adjacent choroid plexus. The mass presented an intermediate signal on T1- and T2-weighted sequences, similar to gray matter, and reduced ADC values on ADC maps compared with white matter, with no enhancement after gadolinium-based contrast injection. After resection, macroscopic examination revealed an organoid structure with leptomeningeal lining and a clear-cut cortex and white matter components. Histology demonstrated normal cerebellum with a double-layered cortex and normal underlying white matter. The cerebellar ectopy was focally covered by bundles of capillary vascular structures covered by a monostratified ependymal cell lining, consistent with choroid plexus. CONCLUSIONS We describe, for the first time to our knowledge, the case of a child with ectopic cerebellar tissue harboring the supratentorial ventricular system. Plausible etiologic mechanism consists in the herniation of the cerebellar germinal tissue into the ventricular system through the ependyma, allowing cell migration to the supratentorial compartment, followed by maturation into the normal cerebellum.
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Affiliation(s)
- Alessandro De Benedictis
- Neurosurgery Unit, Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | - Maria Camilla Rossi-Espagnet
- Neuroradiology Unit, Department of Radiology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy; Neuroradiology Unit, NESMOS Department, Sapienza University, Rome, Italy
| | | | - Sabrina Rossi
- Pathology Unit, Department of Laboratories, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Elena Fontana
- Neuroradiology Unit, Department of Radiology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Franco Randi
- Neurosurgery Unit, Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Viviana Ponzo
- Neurosurgery Unit, Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Carlotta Nucci
- Neurosurgery Unit, Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Giacomo Esposito
- Neurosurgery Unit, Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Giovanni Paternò
- Neurosurgery Unit, Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Carolina Brunetti
- Neurosurgery Unit, Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Alessandra Savioli
- Intensive Care Unit, Department of Emergency, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Andrea Carai
- Neurosurgery Unit, Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Carlo Efisio Marras
- Neurosurgery Unit, Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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Kawashima M, Kobayashi M, Ishizawa K, Fujimaki T. Ectopic cerebellar tissue in the occipital bone: a case report. J Med Case Rep 2017; 11:231. [PMID: 28823247 PMCID: PMC5563901 DOI: 10.1186/s13256-017-1394-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 07/19/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ectopic cerebellar tissue located distantly from the normal cerebellum is very rare, and its pathophysiology remains to be elucidated. CASE PRESENTATION We report an extremely rare case of intraosseous ectopic cerebellum detected incidentally at suboccipital craniotomy in a 46-year-old Japanese woman with hemifacial spasm. She had a small bone defect in the occipital bone, which contained a tiny area of soft tissue surrounded by cerebrospinal fluid connecting to the normal subarachnoid space through a dural opening. Histopathology demonstrated cerebellar cortex tissue consisting of molecular and granular cell layers. CONCLUSIONS This is the first report of glioneuronal ectopia within the skull bone separated from normal brain tissue, and it is important to distinguish this entity from other osteolytic lesions.
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Affiliation(s)
- Mariko Kawashima
- Department of Neurosurgery, Saitama Medical University Hospital, 38 Morohongo, Moroyama-machi, Iruma, Saitama, 350-0495, Japan.
| | - Masahito Kobayashi
- Department of Neurosurgery, Saitama Medical University Hospital, 38 Morohongo, Moroyama-machi, Iruma, Saitama, 350-0495, Japan
| | - Keisuke Ishizawa
- Department of Pathology, Saitama Medical University Hospital, Saitama, Japan
| | - Takamitsu Fujimaki
- Department of Neurosurgery, Saitama Medical University Hospital, 38 Morohongo, Moroyama-machi, Iruma, Saitama, 350-0495, Japan
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