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Suwal S, Katwal S, Chataut D, Lamichhane S, Adhikari A, Baral P, Bhusal A. Rare encounter: Adult-onset temporal lobe schizencephaly with septo-optic dysplasia - a case report on comprehensive diagnosis and management. Radiol Case Rep 2024; 19:2292-2296. [PMID: 38559659 PMCID: PMC10978469 DOI: 10.1016/j.radcr.2024.02.094] [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: 12/24/2023] [Revised: 02/19/2024] [Accepted: 02/25/2024] [Indexed: 04/04/2024] Open
Abstract
This case report presents a 21-year-old male with recurrent seizures attributed to isolated temporal lobe closed-lip schizencephaly coexisting with septo-optic dysplasia. Despite adult-onset seizures, the patient lacked motor deficits, maintaining normal developmental milestones. Comprehensive diagnostic modalities, including MRI revealing temporal lobe atrophy and associated abnormalities, contributed to the unique identification of schizencephaly. The classic triad of septo-optic dysplasia further complicated the clinical spectrum. Financial limitations influenced the predominantly conservative management, highlighting healthcare challenges. This case enhances our understanding of the rare congenital disorder, emphasizing the importance of tailored diagnostics and management strategies for diverse presentations of schizencephaly, particularly in the context of associated congenital anomalies.
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Affiliation(s)
- Sundar Suwal
- Department of Radiology, Maharajgunj Medical College, Kathmandu, Nepal
| | - Shailendra Katwal
- Department of Radiology, Dadeldhura Subregional Hospital, Dadeldhura, Nepal
| | - Dinesh Chataut
- Department of Radiology, Maharajgunj Medical College, Kathmandu, Nepal
| | - Suman Lamichhane
- Department of Radiology, Nepal A.P.F. Hospital, Balambu, Kathmandu, Nepal
| | | | - Pratik Baral
- Department of Medicine, Institute of Medicine, Tribhuwan University Teaching Hospital, Kathmandu, Nepal
| | - Amrit Bhusal
- Department of Radiology, B.P Koirala Institute of Health Science, Dharan, Nepal
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2
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Djukic M, Eiffert H, Gossner J, Nau R. [Congenital malformations of the brain misinterpreted as sequelae of poliomyelitis]. Z Gerontol Geriatr 2023:10.1007/s00391-023-02264-2. [PMID: 38108898 DOI: 10.1007/s00391-023-02264-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 11/15/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Poliomyelitis is an infectious disease of the peripheral motor neurons, which predominantly affects children and causes residual palsies. Because of the oral poliomyelitis vaccination started in Germany in 1960 and 1962 and the following rapid decline of the incidence of this infection, the postpolio syndrome in Germany is a disease of older people. METHODS Since 2008, we have offered a poliomyelitis outpatient consultation at the Center of Geriatrics, Protestant Hospital Göttingen-Weende and have treated 33 patients. RESULTS The spectrum of persistent deficits after poliomyelitis ranges from palsy of single extremities to severe disability with (temporary) ventilator dependence. Many patients suffer from scoliosis or shortening of limbs of different degrees, which promotes degenerative diseases of the spinal cord and joints with secondary myelopathy, injury of spinal nerve roots or peripheral nerves or respiratory failure. The postpolio syndrome is characterized by an increase of the functional deficits after decades of compensation. The palsies of 2 of the 33 patients were not caused by poliomyelitis but by myelomeningocele and schizencephaly, respectively. CONCLUSION The motor deficits acquired in childhood enable the majority of the patients to successfully master their lives. Because of the limited compensatory capacities of postpolio patients, even small increases in the severity of the palsy can cause a severe decline of the functional status and an impairment of the ability to live an independent life. In a substantial proportion of patients with the diagnosis poliomyelitis the symptoms are caused by other diseases.
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Affiliation(s)
- Marija Djukic
- Geriatrisches Zentrum, Evangelisches Krankenhaus Göttingen-Weende, An der Lutter 24, 37075, Göttingen, Deutschland
- Institut für Neuropathologie, Universitätsmedizin Göttingen, Georg-August-Universität Göttingen, Göttingen, Deutschland
| | - Helmut Eiffert
- Institut für Neuropathologie, Universitätsmedizin Göttingen, Georg-August-Universität Göttingen, Göttingen, Deutschland
- Amedes MVZ für Laboratoriumsmedizin, Medizinische Mikrobiologie und Infektiologie, Göttingen, Deutschland
| | - Johannes Gossner
- Institut für Diagnostische und Interventionelle Radiologie, Evangelisches Krankenhaus Göttingen-Weende, Göttingen, Deutschland
| | - Roland Nau
- Geriatrisches Zentrum, Evangelisches Krankenhaus Göttingen-Weende, An der Lutter 24, 37075, Göttingen, Deutschland.
- Institut für Neuropathologie, Universitätsmedizin Göttingen, Georg-August-Universität Göttingen, Göttingen, Deutschland.
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3
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Firn ET, Garcia HH, Rapalino O, Cervantes-Arslanian AM. Imaging of congenital and developmental cystic lesions of the brain: a narrative review. Expert Rev Neurother 2023; 23:1311-1324. [PMID: 37877290 DOI: 10.1080/14737175.2023.2267175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 10/02/2023] [Indexed: 10/26/2023]
Abstract
INTRODUCTION Congenital and developmental intracranial cysts represent a large heterogenous group with varied presentations and etiologies. They can range from normal variants to pathologic lesions often associated with known congenital syndromes or acquired insults. While some are incidentally found, others are symptomatic or may become symptomatic over time. The preferred type of neuroimaging for timely diagnosis helps determine appropriate management and treatment, if indicated. AREAS COVERED In this narrative review article, authors present a comprehensive description of developmental cystic lesions. Imaging descriptions are provided for each type of cystic lesion as well as several representative images. EXPERT OPINION As advanced neuroimaging techniques become more ubiquitous in clinical use, more light may be shed on the natural history of certain intracranial cystic lesions throughout the lifespan. This includes prenatal imaging for early identification and prognostication to surveillance imaging into advanced age to ascertain associations of certain cystic lesions with age-related cognitive dysfunction.
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Affiliation(s)
- Eliza T Firn
- Child Neurology, Boston University School of Medicine, Boston, Massachusetts, USA
- Department of Neurology, Neurosurgery & Medicine, Boston, MA, USA
| | - Hector H Garcia
- Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas, Lima, Peru
| | - Otto Rapalino
- Neuroradiology, Harvard Medical School, Boston, Massachusetts, USA
| | - Anna M Cervantes-Arslanian
- Department of Neurology, Neurosurgery & Medicine, Boston, MA, USA
- Neurology, Neurosurgery, and Medicine, Boston University School of Medicine, Massachusetts, USA
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Kim HJ, Koo YS, Yum MS, Ko TS, Lee SA. Cleft size and type are associate with development of epilepsy and poor seizure control in patients with schizencephaly. Seizure 2022; 98:95-100. [DOI: 10.1016/j.seizure.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 04/03/2022] [Accepted: 04/05/2022] [Indexed: 10/18/2022] Open
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5
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Hoang VT, Hoang TH, Chansomphou V, Doan DT. Traumatic epidural hematoma in a patient with severe schizencephaly. Clin Case Rep 2021; 9:e05150. [PMID: 34938544 PMCID: PMC8665687 DOI: 10.1002/ccr3.5150] [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: 08/30/2021] [Revised: 11/12/2021] [Accepted: 11/19/2021] [Indexed: 11/26/2022] Open
Abstract
Schizencephaly is a rare congenital brain structural abnormality that is not clearly understood and has no specific treatment yet. Therefore, cases related to it should be added to the literature. This report aims to introduce a rare case of severe schizencephaly co-occurring with post-traumatic intracranial epidural hematoma.
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Affiliation(s)
- Van Trung Hoang
- Department of RadiologyThien Hanh HospitalBuon Ma ThuotVietnam
| | - The Huan Hoang
- Department of RadiologyThien Hanh HospitalBuon Ma ThuotVietnam
| | - Vichit Chansomphou
- Department of RadiologySavannakhet Medical‐Diagnostic CenterKaysone PhomvihaneLaos
| | - Dung Tien Doan
- Department of RadiologyCan Tho University of Medicine and PharmacyCan ThoVietnam
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6
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Rocha GFA, Pacheco RL, Latorraca CDOC, Riera R. First academic league of EBM in Brazil: experience report. BMJ Evid Based Med 2021; 26:263-265. [PMID: 32943415 DOI: 10.1136/bmjebm-2020-111547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/20/2020] [Indexed: 11/04/2022]
Affiliation(s)
| | - Rafael Leite Pacheco
- Universidade Federal de São Paulo, São Paulo, Brazil
- Centro Universitário São Camilo, São Paulo, Brazil
| | | | - Rachel Riera
- Universidade Federal de São Paulo, São Paulo, Brazil
- Hospital Sírio-Libanês, São Paulo, Brazil
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7
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Motor Organization in Schizencephaly: Outcomes of Transcranial Magnetic Stimulation and Diffusion Tensor Imaging of Motor Tract Projections Correlate with the Different Domains of Hand Function. BIOMED RESEARCH INTERNATIONAL 2021; 2021:9956609. [PMID: 34527746 PMCID: PMC8437638 DOI: 10.1155/2021/9956609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 07/12/2021] [Accepted: 08/14/2021] [Indexed: 12/30/2022]
Abstract
Objective Schizencephaly is a rare congenital malformation that causes motor impairment. To determine the treatment strategy, each domain of the motor functions should be appropriately evaluated. We correlated a color map of diffusion tensor imaging (DTI) and transcranial magnetic stimulation (TMS) with the hand function test (HFT) to identify the type of hand function that each test (DTI and TMS) reflects. Further, we attempted to demonstrate the motor neuron organization in schizencephaly. Method This retrospective study was conducted on 12 patients with schizencephaly. TMS was conducted in the first dorsal interosseous (FDI), biceps (BB), and deltoid muscles of the upper extremity, and contralateral MEP (cMEP) and ipsilateral MEP (iMEP) were recorded. The HFT included the grip strength, box and block (B&B), and 9-hole peg test. The schizencephalic cleft was confirmed using magnetic resonance imaging, and the corticospinal tract (CST) was identified using the color map of DTI. The symmetry indices for the peduncle and CST at pons level were calculated as the ratios of the cross-sectional area of the less-affected side and that of the more-affected side. Result In the more-affected hemisphere TMS, no iMEP was obtained. In the less-affected hemisphere TMS, the iMEP response was detected in 9 patients and cMEP in all patients, which was similar to the pattern observed in unilateral lesion. Paretic hand grip strength was strongly correlated with the presence of iMEP (p = 0.044). The symmetry index of the color map of DTI was significantly correlated with the B&B (p = 0.008, R 2 = 0.416), whereas the symmetry index of the peduncle was not correlated with all HFTs. Conclusion In patients with schizencephaly, the iMEP response rate is correlated with the hand function related to strength, while the symmetricity of the CST by the color map of DTI is correlated with the hand function associated with dexterity. Additionally, we suggest the possible motor organization pattern of schizencephaly following interhemispheric competition.
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8
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Kinde B, Barkovich AJ, Horton JC. Congenital Visual Field Loss from a Schizencephalic Cleft Damaging Meyer's Loop. Neuroophthalmology 2021; 45:277-280. [PMID: 34366518 DOI: 10.1080/01658107.2020.1844759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
A healthy, asymptomatic woman was referred after incidental discovery of a right superior incongruous hemianopia. Magnetic resonance imaging disclosed a schizencephalic cleft passing through Meyer's loop of the left optic radiation. The lesion may have resulted from a focal vascular accident or disruption of cortical neurogenesis during gestation.
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Affiliation(s)
- Benyam Kinde
- Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA
| | - A James Barkovich
- Department of Radiology, University of California San Francisco, San Francisco, California, USA
| | - Jonathan C Horton
- Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA
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9
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Ilves N, Ilves P, Õunap K, Laugesaar R, Loorits D, Lintrop M, Männamaa M, Metsvaht T. Periventricular Venous Infarction in an Extremely Premature Infant as the Cause of Schizencephaly. JOURNAL OF PEDIATRIC NEUROLOGY 2020. [DOI: 10.1055/s-0039-1697040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
AbstractSchizencephaly is a disorder of neuronal migration which has been hypothesized to arise from vascular ischemic lesion during the early phase of neuroembryogenesis. We describe a case of a premature boy born at 23 weeks of gestation with neonatal stroke. On the first day of life cranial ultrasonography detected a grade II intraventricular hemorrhage and on day 12 periventricular venous infarction. At the postconceptional age of 40 weeks, magnetic resonance imaging revealed a gray matter–lined cleft, suggesting schizencephaly. We have evidence of the pathogenesis of schizencephaly following vascular ischemic stroke early in neurodevelopment before neuronal migration is completed.
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Affiliation(s)
- Norman Ilves
- Radiology Clinic, Tartu University Hospital, Tartu, Estonia
- Department of Radiology, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
| | - Pilvi Ilves
- Radiology Clinic, Tartu University Hospital, Tartu, Estonia
- Department of Radiology, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
| | - Katrin Õunap
- Department of Clinical Genetics, United Laboratories, Tartu University Hospital, Tartu, Estonia
- Department of Clinical Genetics, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
| | - Rael Laugesaar
- Children's Clinic, Tartu University Hospital, Tartu, Estonia
- Department of Pediatrics, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
| | - Dagmar Loorits
- Radiology Clinic, Tartu University Hospital, Tartu, Estonia
| | - Mare Lintrop
- Radiology Clinic, Tartu University Hospital, Tartu, Estonia
- Department of Radiology, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
| | - Mairi Männamaa
- Children's Clinic, Tartu University Hospital, Tartu, Estonia
- Department of Pediatrics, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
| | - Tuuli Metsvaht
- Anesthesiology and Intensive Care Clinic, Tartu University Hospital, Tartu, Estonia
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10
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Alkareem M, Ahmed H, Ahmed G. Unilateral right closed-lip schizencephaly. BMJ Case Rep 2020; 13:13/9/e235004. [PMID: 32928828 DOI: 10.1136/bcr-2020-235004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Schizencephaly is a rare central nervous system (CNS) malformation secondary to neuronal migration defects. The pathogenesis is complex and is secondary to environmental and genetic factors. Clinically, the majority of patients present with varying degrees of motor and psychological disturbances. Imaging plays a cornerstone in the diagnosis by identifying the characteristic lesional features and recognising other associated abnormalities such as an absent septum pellucidum and corpus callosum dysgenesis. Here, we present a male paediatric case who presented with an interestingly asymptomatic unilateral right closed-lip schizencephaly and review the aetiology, clinical presentation and imaging characteristics of the disease and associated literature.
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Affiliation(s)
- Mohamed Alkareem
- Department of Internal Medicine, Tameside General Hospital, Ashton-under-Lyne, Tameside, UK
| | - Hiba Ahmed
- Radiology department, University of Khartoum, Khartoum, Sudan
| | - Gasim Ahmed
- Radiology department, Royal Preston Hospital, Preston, Lancashire, UK
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11
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Baik SW, Kim GW, Ko MH, Seo JH, Won YH, Park SH. An Unusual, Intermediate-Sized Lesion Affecting Motor Organization in a Patient With Schizencephaly: A Case Report. Front Hum Neurosci 2020; 14:258. [PMID: 32765236 PMCID: PMC7381274 DOI: 10.3389/fnhum.2020.00258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 06/11/2020] [Indexed: 11/13/2022] Open
Abstract
Schizencephalies are abnormal clefts of the cerebral hemispheres that result from abnormal late neuronal migration and cortical organization. In the present study, we report a different type of unusual motor organization in a patient with a schizencephalic cleft in the right hemisphere and polymicrogyria in the opposite hemisphere. Despite similar brain pathology affecting the sensorimotor cortex, motor organization differed from previously known bilateral congenital brain lesions. We conducted a transcranial magnetic stimulation (TMS) and diffusion tensor image (DTI) study to confirm the motor organization. In this case, ipsilateral corticospinal projections to the paretic hands were observed during TMS of the less affected hemisphere, along with polymicrogyria, similar to the previous study. However, a crossed corticospinal tract to the paretic hand from the more severely affected hemisphere was observed in this case-a pattern of motor organization that has yet to be reported in this patient population. Our findings indicate that motor organization after early brain injury may be affected by the interhemispheric competition of the corticospinal system and bilateral brain lesions, thereby resulting in unilateral hemiparesis.
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Affiliation(s)
- Sung-Woon Baik
- Department of Physical Medicine and Rehabilitation, Chonbuk National University Hospital, Jeonju, South Korea
| | - Gi-Wook Kim
- Department of Physical Medicine and Rehabilitation, Chonbuk National University Hospital, Jeonju, South Korea.,Research Institue of Clinical Medicine of Chonbuk National University-Biomedical Research Institue of Chonbuk National University Hospital, Jeonju, South Korea.,Translational Research & Clinical Trial Center for Medical Device, Chonbuk National University Hospital, Jeonju, South Korea
| | - Myoung-Hwan Ko
- Department of Physical Medicine and Rehabilitation, Chonbuk National University Hospital, Jeonju, South Korea.,Research Institue of Clinical Medicine of Chonbuk National University-Biomedical Research Institue of Chonbuk National University Hospital, Jeonju, South Korea.,Translational Research & Clinical Trial Center for Medical Device, Chonbuk National University Hospital, Jeonju, South Korea
| | - Jeoung-Hwan Seo
- Department of Physical Medicine and Rehabilitation, Chonbuk National University Hospital, Jeonju, South Korea.,Research Institue of Clinical Medicine of Chonbuk National University-Biomedical Research Institue of Chonbuk National University Hospital, Jeonju, South Korea
| | - Yu-Hui Won
- Department of Physical Medicine and Rehabilitation, Chonbuk National University Hospital, Jeonju, South Korea.,Research Institue of Clinical Medicine of Chonbuk National University-Biomedical Research Institue of Chonbuk National University Hospital, Jeonju, South Korea
| | - Sung-Hee Park
- Department of Physical Medicine and Rehabilitation, Chonbuk National University Hospital, Jeonju, South Korea.,Research Institue of Clinical Medicine of Chonbuk National University-Biomedical Research Institue of Chonbuk National University Hospital, Jeonju, South Korea
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12
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Schiller S, Rosewich H, Grünewald S, Gärtner J. Inborn errors of metabolism leading to neuronal migration defects. J Inherit Metab Dis 2020; 43:145-155. [PMID: 31747049 DOI: 10.1002/jimd.12194] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 11/16/2019] [Accepted: 11/18/2019] [Indexed: 12/15/2022]
Abstract
The development and organisation of the human brain start in the embryonic stage and is a highly complex orchestrated process. It depends on series of cellular mechanisms that are precisely regulated by multiple proteins, signalling pathways and non-protein-coding genes. A crucial process during cerebral cortex development is the migration of nascent neuronal cells to their appropriate positions and their associated differentiation into layer-specific neurons. Neuronal migration defects (NMD) comprise a heterogeneous group of neurodevelopmental disorders including monogenetic disorders and residual syndromes due to damaging factors during prenatal development like infections, maternal diabetes mellitus or phenylketonuria, trauma, and drug use. Multifactorial causes are also possible. Classification into lissencephaly, polymicrogyria, schizencephaly, and neuronal heterotopia is based on the visible morphologic cortex anomalies. Characteristic clinical features of NMDs are severe psychomotor developmental delay, severe intellectual disability, intractable epilepsy, and dysmorphisms. Neurometabolic disorders only form a small subgroup within the large group of NMDs. The prototypes are peroxisomal biogenesis disorders, peroxisomal ß-oxidation defects and congenital disorders of O-glycosylation. The rapid evolution of biotechnology has resulted in an ongoing identification of metabolic and non-metabolic disease genes for NMDs. Nevertheless, we are far away from understanding the specific role of cortical genes and metabolites on spatial and temporal regulation of human cortex development and associated malformations. This limited understanding of the pathogenesis hinders the attempt for therapeutic approaches. In this article, we provide an overview of the most important cortical malformations and potential underlying neurometabolic disorders.
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Affiliation(s)
- Stina Schiller
- Department of Paediatrics and Adolescent Medicine, University Medical Centre Göttingen, Georg August University Göttingen, Göttingen, Germany
| | - Hendrik Rosewich
- Department of Paediatrics and Adolescent Medicine, University Medical Centre Göttingen, Georg August University Göttingen, Göttingen, Germany
| | - Stephanie Grünewald
- Metabolic Unit, Great Ormond Street Hospital and Institute of Child Health, University College London, London, UK
| | - Jutta Gärtner
- Department of Paediatrics and Adolescent Medicine, University Medical Centre Göttingen, Georg August University Göttingen, Göttingen, Germany
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13
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Pfeifer CM, Willard SD, Cornejo P. MRI depiction of fetal brain abnormalities. Acta Radiol Open 2019; 8:2058460119894987. [PMID: 31903224 PMCID: PMC6927204 DOI: 10.1177/2058460119894987] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 11/22/2019] [Indexed: 11/22/2022] Open
Abstract
Intracranial abnormalities are commonly suspected findings on antenatal ultrasound that require evaluation by magnetic resonance imaging. This review depicts multiple abnormalities imaged as a means to guide clinicians in proper diagnosis.
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Affiliation(s)
- Cory M Pfeifer
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Scott D Willard
- Department of Radiology, Nemours Children's Health System, Jacksonville, FL, USA
| | - Patricia Cornejo
- Department of Medical Imaging, Phoenix Children's Hospital, Phoenix, AZ, USA
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14
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Gonzalez JC, Singhapakdi K, Martino AM, Rimawi BH, Bhat R. Unilateral Open-lip Schizencephaly with Tonsillar Herniation in a Preterm Infant. J Pediatr Neurosci 2019; 14:225-227. [PMID: 31908665 PMCID: PMC6935988 DOI: 10.4103/jpn.jpn_75_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 09/04/2019] [Indexed: 11/16/2022] Open
Abstract
Schizencephaly is a rare type of neuronal migration disorder characterized by the presence of a cerebral hemispheric cleft that extends from lateral ventricles to the cortical surface of the brain. We report a rare case of prenatally diagnosed unilateral schizencephaly in a late preterm infant who manifested with rapidly progressive hydrocephalus with massive enlargement of posterior cerebrospinal fluid spaces with tonsillar herniation that was successfully treated with placement of a ventriculoperitoneal shunt.
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Affiliation(s)
| | - Kanya Singhapakdi
- Department of Pediatrics, University of South Alabama, Mobile, Alabama, USA
| | - Anthony M Martino
- Department of Pediatric Neurosurgery, University of South Alabama, Mobile, Alabama, USA
| | - Bassam H Rimawi
- Department of Obstetrics and Gynecology, Maternal-Fetal Medicine Division, University of South Alabama, Mobile, Alabama, USA
| | - Ramachandra Bhat
- Department of Pediatrics, Neonatology Division, University of South Alabama, Mobile, Alabama, USA
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15
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Watanabe J, Okamoto K, Ohashi T, Natsumeda M, Hasegawa H, Oishi M, Miyatake S, Matsumoto N, Fujii Y. Malignant Hyperthermia and Cerebral Venous Sinus Thrombosis After Ventriculoperitoneal Shunt in Infant with Schizencephaly and COL4A1 Mutation. World Neurosurg 2019; 127:446-450. [PMID: 31029817 DOI: 10.1016/j.wneu.2019.04.156] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 04/16/2019] [Accepted: 04/17/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Schizencephaly is a rare congenital central nervous system malformation characterized by linear, thickened clefts of the cerebral mantle. Recently, germline mutations in collagen type IV alpha 1 (COL4A1) have been reported to be a genetic cause of schizencephaly as a result of prenatal stroke. Patients with COL4A1 mutation demonstrate a variety of disease phenotypes. However, little is known about the potential complications of patients with COL4A1 mutations before and after neurologic surgery. CASE DESCRIPTION A 9-month-old boy with schizencephaly and a congenital cataract underwent a ventriculoperitoneal shunt for progressive hydrocephalus. Postoperatively, he developed malignant hyperthermia and cerebral venous thrombosis. Early treatment with dantrolene sodium and hydration was effective. Genetic testing revealed a germline COL4A1 mutation. CONCLUSIONS To our knowledge, malignant hyperthermia and cerebral venous thrombosis have not been reported in the literature in patients with COL4A1 mutations after surgery. Schizencephaly arising from COL4A1 mutations might be a disease prone to these adverse effects because this mutation is known to be associated with venous tortuosity, venous vulnerability, and muscle spasms due to basement membrane protein abnormalities. We need to better understand the wide spectrum of clinical phenotypes of COL4A1 mutations and potential complications in order to better manage surgery of patients with schizencephaly.
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Affiliation(s)
- Jun Watanabe
- Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan.
| | - Kouichirou Okamoto
- Department of Translational Research, Brain Research Institute, Niigata University, Niigata, Japan
| | - Tsukasa Ohashi
- Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Manabu Natsumeda
- Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan
| | - Hitoshi Hasegawa
- Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan
| | - Makoto Oishi
- Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan
| | - Satoko Miyatake
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Naomichi Matsumoto
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Yukihiko Fujii
- Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan
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