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Rijckmans E, Stouffs K, Jansen AC. Diagnostic work-up in malformations of cortical development. Dev Med Child Neurol 2024; 66:974-989. [PMID: 38394064 DOI: 10.1111/dmcn.15882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 01/16/2024] [Accepted: 01/17/2024] [Indexed: 02/25/2024]
Abstract
Malformations of cortical development (MCDs) represent a heterogeneous spectrum of disorders characterized by atypical development of the cerebral cortex. MCDs are most often diagnosed on the basis of imaging, although subtle lesions, such as focal cortical dysplasia, may only be revealed on neuropathology. Different subtypes have been defined, including lissencephaly, heterotopia, cobblestone malformation, polymicrogyria, and dysgyria. Many MCDs are of genetic origin, although acquired factors, such as congenital cytomegalovirus infections and twinning sequence, can lead to similar phenotypes. In this narrative review, we provide an overview of the diagnostic approach to MCDs, which is illustrated with clinical vignettes, on diagnostic pitfalls such as somatic mosaicism and consanguinity, and recognizable phenotypes on imaging, such as tubulinopathies, the lissencephaly spectrum, tuberous sclerosis complex, and FLNA-related periventricular nodular heterotopia.
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Affiliation(s)
- Ellen Rijckmans
- Pediatric Neurology Unit, Department of Pediatrics, KidZ Health Castle, UZ Brussel, Brussels, Belgium
- Neurogenetics Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Katrien Stouffs
- Neurogenetics Research Group, Vrije Universiteit Brussel, Brussels, Belgium
- Center for Medical Genetics, UZ Brussel, Brussels, Belgium
| | - Anna C Jansen
- Neurogenetics Research Group, Vrije Universiteit Brussel, Brussels, Belgium
- Pediatric Neurology Unit, Department of Pediatrics, Antwerp University Hospital, Antwerp, Belgium
- Translational Neurosciences, University of Antwerp, Antwerp, Belgium
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2
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Hosur B, Sinha R, Jain NK, Muthanna BA, Bansal V, Singh S, Kamila G. A Novel Neuroimaging Phenotype in the X-Linked Intellectual Disability with a Missense Mutation of CNKSR2 Gene. Neurol India 2023; 71:980-983. [PMID: 37929438 DOI: 10.4103/0028-3886.388124] [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] [Indexed: 11/07/2023]
Abstract
Background Mental retardation, X-linked, syndromic, Houge type (MRXSHG) is a form of mental retardation characterized by intellectual disability, speech and language impairments, and early-onset seizures. It has been recently recorded in Online Mendelian Inheritance in Man (OMIM), and only 10 cases have been reported in the literature so far. Objective To highlight the novel neuroimaging findings in the pediatric X-linked intellectual disability with a missense mutation of connector enhancer of kinase suppressor of RAS2 (CNKSR2) gene. Material and Methods We present a case of intellectual disability, refractory epilepsy, speech and language delay with subtle dysmorphism, and behavioral issues in an 11-year-old boy with novel neuroimaging findings in a CNKSR2 gene with missense mutation. Results Brain MRI revealed involvement of the basal ganglia, predominantly the neostriatum, and along with the subependymal aspects with focal cavitations involving, especially the bilateral caudate heads. There was relative sparing of the globus pallidi and posterior putamina bilaterally. Whole-exome sequencing identified a hemizygous missense pathogenic variant in the CNKSR2 gene. The mother was found to be an asymptomatic carrier. Conclusion This case report highlights the rare missense mutation in the CNKSR2 gene and abnormal neuroimaging findings, which further provide information about the phenotypic characteristics of X-linked syndromic intellectual disability.
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Affiliation(s)
- Bharat Hosur
- Department of Radiodiagnosis, Command Hospital, Chandimandir, Panchkula, Haryana, India
| | - Rahul Sinha
- Department of Pediatrics and Pediatric Neurology, Command Hospital, Chandimandir, Panchkula, Haryana, India
| | - Narendra K Jain
- Department of Radiodiagnosis, Command Hospital, Chandimandir, Panchkula, Haryana, India
| | | | - Vandana Bansal
- Department of Pediatrics and Pediatric Neurology, Command Hospital, Chandimandir, Panchkula, Haryana, India
| | - Sonali Singh
- Department of Pediatrics, All India Institute of Medical Sciences, Delhi, India
| | - Gautam Kamila
- Department of Pediatrics, All India Institute of Medical Sciences, Delhi, India
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3
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Lucignani G, Guarnera A, Rossi-Espagnet MC, Moltoni G, Antonelli A, Figà Talamanca L, Carducci C, Calo Carducci FI, Napolitano A, Gandolfo C, Campi F, Auriti C, Parazzini C, Longo D. From Fetal to Neonatal Neuroimaging in TORCH Infections: A Pictorial Review. CHILDREN (BASEL, SWITZERLAND) 2022; 9:1210. [PMID: 36010101 PMCID: PMC9406729 DOI: 10.3390/children9081210] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 08/06/2022] [Accepted: 08/09/2022] [Indexed: 11/16/2022]
Abstract
Congenital infections represent a challenging and varied clinical scenario in which the brain is frequently involved. Therefore, fetal and neonatal neuro-imaging plays a pivotal role in reaching an accurate diagnosis and in predicting the clinical outcome. Congenital brain infections are characterized by various clinical manifestations, ranging from nearly asymptomatic diseases to syndromic disorders, often associated with severe neurological symptoms. Brain damage results from the complex interaction among the infectious agent, its specific cellular tropism, and the stage of development of the central nervous system at the time of the maternal infection. Therefore, neuroradiological findings vary widely and are the result of complex events. An early detection is essential to establishing a proper diagnosis and prognosis, and to guarantee an optimal and prompt therapeutic perinatal management. Recently, emerging infective agents (i.e., Zika virus and SARS-CoV2) have been related to possible pre- and perinatal brain damage, thus expanding the spectrum of congenital brain infections. The purpose of this pictorial review is to provide an overview of the current knowledge on fetal and neonatal brain neuroimaging patterns in congenital brain infections used in clinical practice.
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Affiliation(s)
- Giulia Lucignani
- Neuroradiology Unit, Imaging Department, Bambino Gesù Children’s Hospital IRCCS, 00146 Rome, Italy
| | - Alessia Guarnera
- Neuroradiology Unit, Imaging Department, Bambino Gesù Children’s Hospital IRCCS, 00146 Rome, Italy
| | | | - Giulia Moltoni
- Neuroradiology Unit, NESMOS Department, Sant’Andrea Hospital, La Sapienza University, 00146 Rome, Italy
| | - Amanda Antonelli
- Neuroradiology Unit, Imaging Department, Bambino Gesù Children’s Hospital IRCCS, 00146 Rome, Italy
- Department of Radiology, IRCCS Materno Infantile Burlo Garofolo, Via dell’Istria 65, 34137 Trieste, Italy
| | - Lorenzo Figà Talamanca
- Neuroradiology Unit, Imaging Department, Bambino Gesù Children’s Hospital IRCCS, 00146 Rome, Italy
| | - Chiara Carducci
- Neuroradiology Unit, Imaging Department, Bambino Gesù Children’s Hospital IRCCS, 00146 Rome, Italy
| | | | - Antonio Napolitano
- Medical Physics Unit, Risk Management Enterprise, Bambino Gesù Children’s Hospital IRCCS, 00146 Rome, Italy
| | - Carlo Gandolfo
- Neuroradiology Unit, Imaging Department, Bambino Gesù Children’s Hospital IRCCS, 00146 Rome, Italy
| | - Francesca Campi
- Neonatal Intensive Care Unit, Department of Medical and Surgical Neonatology, Bambino Gesù Children’s Hospital IRCCS, 00146 Rome, Italy
| | - Cinzia Auriti
- Neonatal Intensive Care Unit, Department of Medical and Surgical Neonatology, Bambino Gesù Children’s Hospital IRCCS, 00146 Rome, Italy
| | - Cecilia Parazzini
- Department of Pediatric Radiology and Neuroradiology, V. Buzzi Children’s Hospital, Via Castelvetro 32, 20154 Milan, Italy
| | - Daniela Longo
- Neuroradiology Unit, Imaging Department, Bambino Gesù Children’s Hospital IRCCS, 00146 Rome, Italy
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Hehnly C, Ssentongo P, Bebell LM, Burgoine K, Bazira J, Fronterre C, Kumbakumba E, Mulondo R, Mbabazi-Kabachelor E, Morton SU, Ngonzi J, Ochora M, Olupot-Olupot P, Mugamba J, Onen J, Roberts DJ, Sheldon K, Sinnar SA, Smith J, Ssenyonga P, Kiwanuka J, Paulson JN, Meier FA, Ericson JE, Broach JR, Schiff SJ. Cytomegalovirus infections in infants in Uganda: Newborn-mother pairs, neonates with sepsis, and infants with hydrocephalus. Int J Infect Dis 2022; 118:24-33. [PMID: 35150915 PMCID: PMC9058984 DOI: 10.1016/j.ijid.2022.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 01/30/2022] [Accepted: 02/04/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To estimate the prevalence of cytomegalovirus (CMV) infections among newborn-mother pairs, neonates with sepsis, and infants with hydrocephalus in Uganda. DESIGN AND METHODS Three populations-newborn-mother pairs, neonates with sepsis, and infants (≤3 months) with nonpostinfectious (NPIH) or postinfectious (PIH) hydrocephalus-were evaluated for CMV infection at 3 medical centers in Uganda. Quantitative PCR (qPCR) was used to characterize the prevalence of CMV. RESULTS The overall CMV prevalence in 2498 samples across all groups was 9%. In newborn-mother pairs, there was a 3% prevalence of cord blood CMV positivity and 33% prevalence of maternal vaginal shedding. In neonates with clinical sepsis, there was a 2% CMV prevalence. Maternal HIV seropositivity (adjusted odds ratio [aOR] 25.20; 95% confidence interval [CI] 4.43-134.26; p = 0.0001), residence in eastern Uganda (aOR 11.06; 95% CI 2.30-76.18; p = 0.003), maternal age <25 years (aOR 4.54; 95% CI 1.40-19.29; p = 0.02), and increasing neonatal age (aOR 1.08 for each day older; 95% CI 1.00-1.16; p = 0.05), were associated risk factors for CMV in neonates with clinical sepsis. We found a 2-fold higher maternal vaginal shedding in eastern (45%) vs western (22%) Uganda during parturition (n = 22/49 vs 11/50, the Fisher exact test; p = 0.02). In infants with PIH, the prevalence in blood was 24% and in infants with NPIH, it was 20%. CMV was present in the cerebrospinal fluid (CSF) of 13% of infants with PIH compared with 0.5% of infants with NPIH (n = 26/205 vs 1/194, p < 0.0001). CONCLUSIONS Our findings highlight that congenital and postnatal CMV prevalence is substantial in this African setting, and the long-term consequences are uncharacterized.
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Affiliation(s)
- Christine Hehnly
- Institute for Personalized Medicine, Department of Biochemistry and Molecular Biology, The Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Paddy Ssentongo
- Center for Neural Engineering, Department of Engineering Science and Mechanics, The Pennsylvania State University, University Park, PA, USA; Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Lisa M Bebell
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Kathy Burgoine
- Neonatal Unit, Department of Paediatrics and Child Health, Mbale Regional Referral Hospital, Mbale, Uganda; Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom; Mbale Clinical Research Institute, Mbale Regional Referral Hospital, Mbale, Uganda
| | - Joel Bazira
- Department of Microbiology, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Claudio Fronterre
- Centre for Health Informatics, Computing, and Statistics, Lancaster University, Lancaster, United Kingdom
| | - Elias Kumbakumba
- Department of Pediatrics, Mbarara University of Science and Technology, Mbarara, Uganda
| | | | | | - Sarah U Morton
- Division of Newborn Medicine, Boston Children's Hospital and Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Joseph Ngonzi
- Department of Obstetrics and Gynaecology, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Moses Ochora
- Centre for Health Informatics, Computing, and Statistics, Lancaster University, Lancaster, United Kingdom
| | - Peter Olupot-Olupot
- Mbale Clinical Research Institute, Mbale Regional Referral Hospital, Mbale, Uganda; Busitema University, Busitema, Uganda
| | - John Mugamba
- CURE Children's Hospital of Uganda, Mbale, Uganda
| | - Justin Onen
- Mulago National Referral Hospital, Kampala, Uganda
| | - Drucilla J Roberts
- Department of Pathology, Massachusetts General Hospital, Boston, and Harvard Medical School, Boston, MA, USA
| | - Kathryn Sheldon
- Institute for Personalized Medicine, Department of Biochemistry and Molecular Biology, The Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Shamim A Sinnar
- Department of Medicine, The Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Jasmine Smith
- Institute for Personalized Medicine, Department of Biochemistry and Molecular Biology, The Pennsylvania State University College of Medicine, Hershey, PA, USA
| | | | - Julius Kiwanuka
- Department of Pediatrics, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Joseph N Paulson
- Department of Biostatistics, Product Development, Genentech Inc., San Francisco, CA, USA
| | | | - Jessica E Ericson
- Division of Pediatric Infectious Disease, The Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - James R Broach
- Institute for Personalized Medicine, Department of Biochemistry and Molecular Biology, The Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Steven J Schiff
- Center for Neural Engineering, Department of Engineering Science and Mechanics, The Pennsylvania State University, University Park, PA, USA; Center for Infectious Disease Dynamics, and Department of Physics, The Pennsylvania State University, University Park, PA, USA; Department of Neurosurgery, The Pennsylvania State University College of Medicine, Hershey, PA, USA.
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Luckowitsch M, Rudolph H, Bochennek K, Porto L, Lehrnbecher T. Central Nervous System Mold Infections in Children with Hematological Malignancies: Advances in Diagnosis and Treatment. J Fungi (Basel) 2021; 7:168. [PMID: 33652605 PMCID: PMC7996787 DOI: 10.3390/jof7030168] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 02/21/2021] [Accepted: 02/22/2021] [Indexed: 12/11/2022] Open
Abstract
The incidence of invasive mold disease (IMD) has significantly increased over the last decades, and IMD of the central nervous system (CNS) is a particularly severe form of this infection. Solid data on the incidence of CNS IMD in the pediatric setting are lacking, in which Aspergillus spp. is the most prevalent pathogen, followed by mucorales. CNS IMD is difficult to diagnose, and although imaging tools such as magnetic resonance imaging have considerably improved, these techniques are still unspecific. As microscopy and culture have a low sensitivity, non-culture-based assays such as the detection of fungal antigens (e.g., galactomannan or beta-D-glucan) or the detection of fungal nucleic acids by molecular assays need to be validated in children with suspected CNS IMD. New and potent antifungal compounds helped to improve outcome of CNS IMD, but not all agents are approved for children and a pediatric dosage has not been established. Therefore, studies have to rapidly evaluate dosage, safety and efficacy of antifungal compounds in the pediatric setting. This review will summarize the current knowledge on diagnostic tools and on the management of CNS IMD with a focus on pediatric patients.
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Affiliation(s)
- Marie Luckowitsch
- Division of Pediatric Hematology and Oncology, Hospital for Children and Adolescents, University Hospital Frankfurt, Goethe University, 60590 Frankfurt am Main, Germany; (M.L.); (H.R.); (K.B.)
| | - Henriette Rudolph
- Division of Pediatric Hematology and Oncology, Hospital for Children and Adolescents, University Hospital Frankfurt, Goethe University, 60590 Frankfurt am Main, Germany; (M.L.); (H.R.); (K.B.)
| | - Konrad Bochennek
- Division of Pediatric Hematology and Oncology, Hospital for Children and Adolescents, University Hospital Frankfurt, Goethe University, 60590 Frankfurt am Main, Germany; (M.L.); (H.R.); (K.B.)
| | - Luciana Porto
- Institute for Neuroradiology, University Hospital Frankfurt, Goethe University, 60590 Frankfurt am Main, Germany;
| | - Thomas Lehrnbecher
- Division of Pediatric Hematology and Oncology, Hospital for Children and Adolescents, University Hospital Frankfurt, Goethe University, 60590 Frankfurt am Main, Germany; (M.L.); (H.R.); (K.B.)
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Galadanci AA, DeBaun MR, Galadanci NA. Neurologic complications in children under five years with sickle cell disease. Neurosci Lett 2019; 706:201-206. [PMID: 31039424 DOI: 10.1016/j.neulet.2019.04.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 02/27/2019] [Accepted: 04/12/2019] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Sickle Cell Disease (SCD) is one of the most common genetic diseases in the world affecting every organ. The major challenge in the medical care of children with SCD is preventing end-organ dysfunction, particularly the brain. Major neurologic complications in children less than five years with SCD include, but are not limited to, Silent cerebral infarct, cerebral sinus thrombosis, epilepsy, reversible encephalopathy syndrome, and ischemic and hemorrhagic stroke. Recurrent headaches and migraine are not rare in children under five years with SCD. This review will focus on the neurologic complications and the description of the modifiable risk factors in children less than 5 years of age with emphasis on differences between high and low resource settings. AREAS COVERED Neurologic complications of children under 5 years of age and the modifiable risk factors. The PUBMED database was searched using medical subject headings (MeSH) and keywords for articles regarding neurologic complications in children under 5 years of age. CONCLUSION Neurologic complications in children under five years of age with SCD may be more frequent than currently reported, among which Silent cerebral infarct and cognitive impairment are the most common.
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Affiliation(s)
- Aisha A Galadanci
- Department of Hematology and Blood Transfusion, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Michael R DeBaun
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Najibah A Galadanci
- Department of Epidemiology, UAB School of Public Health, University of Alabama at Birmingham, 1665 University Blvd, Birmingham, AL 35233, USA.
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Bautista LE, Herrera VM. An assessment of public health surveillance of Zika virus infection and potentially associated outcomes in Latin America. BMC Public Health 2018; 18:656. [PMID: 29793453 PMCID: PMC5968501 DOI: 10.1186/s12889-018-5566-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 05/14/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We evaluated whether outbreaks of Zika virus (ZIKV) infection, newborn microcephaly, and Guillain-Barré syndrome (GBS) in Latin America may be detected through current surveillance systems, and how cases detected through surveillance may increase health care burden. METHODS We estimated the sensitivity and specificity of surveillance case definitions using published data. We assumed a 10% ZIKV infection risk during a non-outbreak period and hypothetical increases in risk during an outbreak period. We used sensitivity and specificity estimates to correct for non-differential misclassification, and calculated a misclassification-corrected relative risk comparing both periods. To identify the smallest hypothetical increase in risk resulting in a detectable outbreak we compared the misclassification-corrected relative risk to the relative risk corresponding to the upper limit of the endemic channel (mean + 2 SD). We also estimated the proportion of false positive cases detected during the outbreak. We followed the same approach for microcephaly and GBS, but assumed the risk of ZIKV infection doubled during the outbreak, and ZIKV infection increased the risk of both diseases. RESULTS ZIKV infection outbreaks were not detectable through non-serological surveillance. Outbreaks were detectable through serologic surveillance if infection risk increased by at least 10%, but more than 50% of all cases were false positive. Outbreaks of severe microcephaly were detected if ZIKV infection increased prevalence of this condition by at least 24.0 times. When ZIKV infection did not increase the prevalence of severe microcephaly, 34.7 to 82.5% of all cases were false positive, depending on diagnostic accuracy. GBS outbreaks were detected if ZIKV infection increased the GBS risk by at least seven times. For optimal GBS diagnosis accuracy, the proportion of false positive cases ranged from 29 to 54% and from 45 to 56% depending on the incidence of GBS mimics. CONCLUSIONS Current surveillance systems have a low probability of detecting outbreaks of ZIKV infection, severe microcephaly, and GBS, and could result in significant increases in health care burden, due to the detection of large numbers of false positive cases. In view of these limitations, Latin American countries should consider alternative options for surveillance.
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Affiliation(s)
- Leonelo E Bautista
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin at Madison, 610 Walnut Street, WARF 703, Madison, WI, 53726-2397, USA.
| | - Víctor M Herrera
- Center for Biomedical Research, Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia
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Baltimore RS, Nimkin K, Sparger KA, Pierce VM, Plotkin SA. Case 4-2018: A Newborn with Thrombocytopenia, Cataracts, and Hepatosplenomegaly. N Engl J Med 2018; 378:564-572. [PMID: 29414276 DOI: 10.1056/nejmcpc1706110] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Robert S Baltimore
- From the Departments of Pediatrics and Infection Prevention, Yale New Haven Children's Hospital, and the Departments of Pediatrics and Epidemiology, Yale School of Medicine and Yale School of Public Health, New Haven, CT (R.S.B.); the Departments of Radiology (K.N.), Pediatrics (K.A.S., V.M.P.), and Pathology (V.M.P.), Massachusetts General Hospital, and the Departments of Radiology (K.N.), Pediatrics (K.A.S.), and Pathology (V.M.P.), Harvard Medical School - both in Boston; and the Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (S.A.P.)
| | - Katherine Nimkin
- From the Departments of Pediatrics and Infection Prevention, Yale New Haven Children's Hospital, and the Departments of Pediatrics and Epidemiology, Yale School of Medicine and Yale School of Public Health, New Haven, CT (R.S.B.); the Departments of Radiology (K.N.), Pediatrics (K.A.S., V.M.P.), and Pathology (V.M.P.), Massachusetts General Hospital, and the Departments of Radiology (K.N.), Pediatrics (K.A.S.), and Pathology (V.M.P.), Harvard Medical School - both in Boston; and the Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (S.A.P.)
| | - Katherine A Sparger
- From the Departments of Pediatrics and Infection Prevention, Yale New Haven Children's Hospital, and the Departments of Pediatrics and Epidemiology, Yale School of Medicine and Yale School of Public Health, New Haven, CT (R.S.B.); the Departments of Radiology (K.N.), Pediatrics (K.A.S., V.M.P.), and Pathology (V.M.P.), Massachusetts General Hospital, and the Departments of Radiology (K.N.), Pediatrics (K.A.S.), and Pathology (V.M.P.), Harvard Medical School - both in Boston; and the Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (S.A.P.)
| | - Virginia M Pierce
- From the Departments of Pediatrics and Infection Prevention, Yale New Haven Children's Hospital, and the Departments of Pediatrics and Epidemiology, Yale School of Medicine and Yale School of Public Health, New Haven, CT (R.S.B.); the Departments of Radiology (K.N.), Pediatrics (K.A.S., V.M.P.), and Pathology (V.M.P.), Massachusetts General Hospital, and the Departments of Radiology (K.N.), Pediatrics (K.A.S.), and Pathology (V.M.P.), Harvard Medical School - both in Boston; and the Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (S.A.P.)
| | - Stanley A Plotkin
- From the Departments of Pediatrics and Infection Prevention, Yale New Haven Children's Hospital, and the Departments of Pediatrics and Epidemiology, Yale School of Medicine and Yale School of Public Health, New Haven, CT (R.S.B.); the Departments of Radiology (K.N.), Pediatrics (K.A.S., V.M.P.), and Pathology (V.M.P.), Massachusetts General Hospital, and the Departments of Radiology (K.N.), Pediatrics (K.A.S.), and Pathology (V.M.P.), Harvard Medical School - both in Boston; and the Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (S.A.P.)
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9
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Snyder E, Hwang M, Soares BP, Tekes A. Ultrasound and CT of the posterior fossa in neonates. HANDBOOK OF CLINICAL NEUROLOGY 2018; 154:205-217. [PMID: 29903440 DOI: 10.1016/b978-0-444-63956-1.00012-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Ultrasound, CT and MRI may all be used in the evaluation of the posterior fossa in neonates depending on the clinical scenario. Ultrasonography is particularly valuable for the evaluation of the neonatal brain because of the lack of ionizing radiation and the ability to perform exams at the bedside and, importantly, advancements in ultrasound technology now allow for diagnostic-quality imaging. While CT is still the initial imaging modality of choice in most neurologic emergencies, in the neonate, ultrasound is the first line in nontraumatic emergencies. The goal of this chapter is to discuss the ultrasound technique for evaluation of the cerebellum, to describe the normal sonographic and CT appearance of posterior fossa and to provide the classical findings of the most common cerebellar abnormalities. While ultrasound is able to accurately diagnosis a majority of cerebellar abnormalities in neonates, subsequent MR imaging remains essential to confirm findings and to detect associated abnormalities.
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Affiliation(s)
- Elizabeth Snyder
- Division of Pediatric Radiology and Pediatric Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, MD, United States
| | - Misun Hwang
- Division of Pediatric Radiology and Pediatric Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, MD, United States
| | - Bruno P Soares
- Division of Pediatric Radiology and Pediatric Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, MD, United States
| | - Aylin Tekes
- Division of Pediatric Radiology and Pediatric Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, MD, United States.
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Petribu NCDL, Aragao MDFV, van der Linden V, Parizel P, Jungmann P, Araújo L, Abath M, Fernandes A, Brainer-Lima A, Holanda A, Mello R, Sarteschi C, Duarte MDCMB. Follow-up brain imaging of 37 children with congenital Zika syndrome: case series study. BMJ 2017; 359:j4188. [PMID: 29030384 PMCID: PMC5639438 DOI: 10.1136/bmj.j4188] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Objective To compare initial brain computed tomography (CT) scans with follow-up CT scans at one year in children with congenital Zika syndrome, focusing on cerebral calcifications.Design Case series study.Setting Barão de Lucena Hospital, Pernambuco state, Brazil.Participants 37 children with probable or confirmed congenital Zika syndrome during the microcephaly outbreak in 2015 who underwent brain CT shortly after birth and at one year follow-up.Main outcome measure Differences in cerebral calcification patterns between initial and follow-up scans.Results 37 children were evaluated. All presented cerebral calcifications on the initial scan, predominantly at cortical-white matter junction. At follow-up the calcifications had diminished in number, size, or density, or a combination in 34 of the children (92%, 95% confidence interval 79% to 97%), were no longer visible in one child, and remained unchanged in two children. No child showed an increase in calcifications. The calcifications at the cortical-white matter junction which were no longer visible at follow-up occurred predominately in the parietal and occipital lobes. These imaging changes were not associated with any clear clinical improvements.Conclusion The detection of cerebral calcifications should not be considered a major criterion for late diagnosis of congenital Zika syndrome, nor should the absence of calcifications be used to exclude the diagnosis.
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Affiliation(s)
| | | | - Vanessa van der Linden
- Barão de Lucena Hospital, Recife, Brazil
- Association for Assistance of Disabled Children, Recife, Brazil
| | | | | | | | | | | | | | - Arthur Holanda
- Medical School, Federal University of Pernambuco, Recife, Brazil
| | - Roberto Mello
- Medical School, Federal University of Pernambuco, Recife, Brazil
| | - Camila Sarteschi
- The Research Center Aggeu Magalhães (CPqAM), Oswaldo Cruz Foundation (Fiocruz) unit, Pernambuco, Brazil
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11
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Ajdacic-Gross V, Aleksandrowicz A, Rodgers S, Mutsch M, Tesic A, Müller M, Kawohl W, Rössler W, Seifritz E, Castelao E, Strippoli MPF, Vandeleur C, von Känel R, Paolicelli R, Landolt MA, Witthauer C, Lieb R, Preisig M. Infectious, atopic and inflammatory diseases, childhood adversities and familial aggregation are independently associated with the risk for mental disorders: Results from a large Swiss epidemiological study. World J Psychiatry 2016; 6:419-430. [PMID: 28078206 PMCID: PMC5183994 DOI: 10.5498/wjp.v6.i4.419] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 09/08/2016] [Accepted: 10/09/2016] [Indexed: 02/05/2023] Open
Abstract
AIM To examine the associations between mental disorders and infectious, atopic, inflammatory diseases while adjusting for other risk factors.
METHODS We used data from PsyCoLaus, a large Swiss Population Cohort Study (n = 3720; age range 35-66). Lifetime diagnoses of mental disorders were grouped into the following categories: Neurodevelopmental, anxiety (early and late onset), mood and substance disorders. They were regressed on infectious, atopic and other inflammatory diseases adjusting for sex, educational level, familial aggregation, childhood adversities and traumatic experiences in childhood. A multivariate logistic regression was applied to each group of disorders. In a complementary analysis interactions with sex were introduced via nested effects.
RESULTS Associations with infectious, atopic and other chronic inflammatory diseases were observable together with consistent effects of childhood adversities and familial aggregation, and less consistent effects of trauma in each group of mental disorders. Streptococcal infections were associated with neurodevelopmental disorders (men), and measles/mumps/rubella-infections with early and late anxiety disorders (women). Gastric inflammatory diseases took effect in mood disorders (both sexes) and in early disorders (men). Similarly, irritable bowel syndrome was prominent in a sex-specific way in mood disorders in women, and, moreover, was associated with early and late anxiety disorders. Atopic diseases were associated with late anxiety disorders. Acne (associations with mood disorders in men) and psoriasis (associations with early anxiety disorders in men and mood disorders in women) contributed sex-specific results. Urinary tract infections were associated with mood disorders and, in addition, in a sex-specific way with late anxiety disorders (men), and neurodevelopmental and early anxiety disorders (women).
CONCLUSION Infectious, atopic and inflammatory diseases are important risk factors for all groups of mental disorders. The sexual dimorphism of the associations is pronounced.
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12
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Shah T, Luck S, Sharland M, Kadambari S, Heath P, Lyall H. Fifteen-minute consultation: diagnosis and management of congenital CMV. Arch Dis Child Educ Pract Ed 2016; 101:232-5. [PMID: 27307463 DOI: 10.1136/archdischild-2015-309656] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 05/24/2016] [Indexed: 11/04/2022]
Abstract
Congenital cytomegalovirus (cCMV) infection can result in permanent neurological problems and is a potentially preventable cause of sensorineural hearing loss in the UK. There is an urgency to diagnose and assess cCMV as antiviral treatment and has only been shown to be effective if started in the first 4 weeks of life. A recent randomised controlled trial of 6 months of treatment using oral valganciclovir has shown modest benefit in preventing hearing deterioration and in improving some neurodevelopmental outcomes. Parents and clinicians need to make a timely and informed choice regarding antiviral treatment and ensure that relevant non-pharmaceutical interventions are considered. This paper brings together the current evidence regarding the diagnosis and treatment of cCMV, consensus from two paediatric infectious diseases centres and outlines research priorities.
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Affiliation(s)
- Tejshri Shah
- Paediatric Infectious Diseases, St. Mary's Hospital, Imperial College NHS Healthcare Trust, London, UK
| | - Suzanne Luck
- Department of Paediatrics, Kingston Hospital NHS Foundation Trust, London, UK Paediatric Infectious Diseases Research Group, St George's University of London, London, UK
| | - Mike Sharland
- Paediatric Infectious Diseases Research Group, St George's University of London, London, UK
| | - Seilesh Kadambari
- Paediatric Infectious Diseases Research Group, St George's University of London, London, UK
| | - Paul Heath
- Paediatric Infectious Diseases Research Group, St George's University of London, London, UK
| | - Hermione Lyall
- Paediatric Infectious Diseases, St. Mary's Hospital, Imperial College NHS Healthcare Trust, London, UK
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13
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Ng YS, Alston CL, Diodato D, Morris AA, Ulrick N, Kmoch S, Houštěk J, Martinelli D, Haghighi A, Atiq M, Gamero MA, Garcia-Martinez E, Kratochvílová H, Santra S, Brown RM, Brown GK, Ragge N, Monavari A, Pysden K, Ravn K, Casey JP, Khan A, Chakrapani A, Vassallo G, Simons C, McKeever K, O'Sullivan S, Childs AM, Østergaard E, Vanderver A, Goldstein A, Vogt J, Taylor RW, McFarland R. The clinical, biochemical and genetic features associated with RMND1-related mitochondrial disease. J Med Genet 2016; 53:768-775. [PMID: 27412952 PMCID: PMC5264221 DOI: 10.1136/jmedgenet-2016-103910] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 05/11/2016] [Accepted: 05/26/2016] [Indexed: 12/16/2022]
Abstract
Background Mutations in the RMND1 (Required for Meiotic Nuclear Division protein 1) gene have recently been linked to infantile onset mitochondrial disease characterised by multiple mitochondrial respiratory chain defects. Methods We summarised the clinical, biochemical and molecular genetic investigation of an international cohort of affected individuals with RMND1 mutations. In addition, we reviewed all the previously published cases to determine the genotype–phenotype correlates and performed survival analysis to identify prognostic factors. Results We identified 14 new cases from 11 pedigrees that harbour recessive RMND1 mutations, including 6 novel variants: c.533C>A, p.(Thr178Lys); c.565C>T, p.(Gln189*); c.631G>A, p.(Val211Met); c.1303C>T, p.(Leu435Phe); c.830+1G>A and c.1317+1G>T. Together with all previously published cases (n=32), we show that congenital sensorineural deafness, hypotonia, developmental delay and lactic acidaemia are common clinical manifestations with disease onset under 2 years. Renal involvement is more prevalent than seizures (66% vs 44%). In addition, median survival time was longer in patients with renal involvement compared with those without renal disease (6 years vs 8 months, p=0.009). The neurological phenotype also appears milder in patients with renal involvement. Conclusions The clinical phenotypes and prognosis associated with RMND1 mutations are more heterogeneous than that were initially described. Regular monitoring of kidney function is imperative in the clinical practice in light of nephropathy being present in over 60% of cases. Furthermore, renal replacement therapy should be considered particularly in those patients with mild neurological manifestation as shown in our study that four recipients of kidney transplant demonstrate good clinical outcome to date.
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Affiliation(s)
- Yi Shiau Ng
- Wellcome Trust Centre for Mitochondrial Research, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Charlotte L Alston
- Wellcome Trust Centre for Mitochondrial Research, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Daria Diodato
- Neuromuscular and Neurodegenerative Disease Unit, Children Research Hospital Bambino Gesù, Rome, Italy
| | - Andrew A Morris
- Department of Genetic Medicine, Central Manchester University Hospitals NHS Foundation Trust, St Mary's Hospital, Manchester, UK
| | - Nicole Ulrick
- Department of Neurology, George Washington University Medical School, Children's National Health System, Washington, DC, USA
| | - Stanislav Kmoch
- First Faculty of Medicine, Institute for Inherited Metabolic Disorders, Charles University in Prague, Prague, Czech Republic
| | - Josef Houštěk
- Institute of Physiology, Academy of Sciences of the Czech Republic, Prague, Czech Republic
| | - Diego Martinelli
- Division of Metabolism, Children Research Hospital Bambino Gesù, Rome, Italy
| | - Alireza Haghighi
- Department of Genetics, Harvard Medical School, Boston, Massachusetts, USA.,Department of Medicine and the Howard Hughes Medical Institute, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Mehnaz Atiq
- Department of Pediatrics, Aga Khan University, Karachi, Pakistan
| | | | | | - Hana Kratochvílová
- Department of Pediatrics and Adolescent Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
| | - Saikat Santra
- Department of Clinical Inherited Metabolic Disorders, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK
| | - Ruth M Brown
- Oxford Medical Genetics Laboratories, Oxford University Hospitals NHS Foundation Trust, The Churchill Hospital, Oxford, UK
| | - Garry K Brown
- Oxford Medical Genetics Laboratories, Oxford University Hospitals NHS Foundation Trust, The Churchill Hospital, Oxford, UK
| | - Nicola Ragge
- Clinical Genetics Unit, West Midlands Regional Genetics Service, Birmingham Women's NHS Foundation Trust, Birmingham, UK.,Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Ahmad Monavari
- National Centre for Inherited Metabolic Disorders, Temple Street Children's University Hospital, Dublin, Ireland
| | - Karen Pysden
- Department of Paediatric Medicine, Leeds General Infirmary, Leeds, UK
| | - Kirstine Ravn
- Department of Clinical Genetics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Jillian P Casey
- Department of Clinical Genetics, Temple Street Children's University Hospital, Dublin, Ireland
| | - Arif Khan
- Leicester Children's Hospital, Leicester Royal Infirmary, Leicester, UK
| | - Anupam Chakrapani
- Department of Metabolic Medicine, Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Grace Vassallo
- Department of Paediatric Neurology, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Cas Simons
- Institute for Molecular Bioscience, University of Queensland, St. Lucia, Queensland, Australia
| | - Karl McKeever
- Department of Paediatric Medicine, The Royal Belfast Hospital for Sick Children, Belfast, UK
| | - Siobhan O'Sullivan
- Department of Paediatric Medicine, The Royal Belfast Hospital for Sick Children, Belfast, UK
| | - Anne-Marie Childs
- Department of Paediatric Medicine, Leeds General Infirmary, Leeds, UK
| | - Elsebet Østergaard
- Department of Clinical Genetics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Adeline Vanderver
- Department of Neurology, George Washington University Medical School, Children's National Health System, Washington, DC, USA
| | - Amy Goldstein
- Division of Child Neurology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Julie Vogt
- Department of Medical and Molecular Genetics, Centre for Rare Diseases and Personalised Medicine, School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UK
| | - Robert W Taylor
- Wellcome Trust Centre for Mitochondrial Research, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Robert McFarland
- Wellcome Trust Centre for Mitochondrial Research, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
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14
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Ajdacic-Gross V, Aleksandrowicz A, Rodgers S, Müller M, Kawohl W, Rössler W, Castelao E, Vandeleur C, von Känel R, Mutsch M, Lieb R, Preisig M. Social Phobia Is Associated with Delayed Onset of Chickenpox, Measles, and Mumps Infections. Front Psychiatry 2016; 7:203. [PMID: 28082921 PMCID: PMC5186793 DOI: 10.3389/fpsyt.2016.00203] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 12/08/2016] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE Evidence showing that infectious diseases in childhood play an important role in the etiopathogenesis of neurodevelopmental and other mental disorders is growing. The aim of this study was to explore the timing of common childhood diseases in early-onset anxiety disorders. MATERIALS AND METHODS We analyzed data from PsyCoLaus, a large Swiss Population Cohort Study (N = 3720). In this study, we regressed overanxious disorder, separation anxiety disorder, social phobia, and specific phobias on the age of onset of several childhood diseases, always adjusting for the other anxiety disorders listed above and for sex. RESULTS The timing of viral childhood diseases (chickenpox, measles, and mumps) was consistently delayed in social phobia, notably both in men and women. We found no evidence for a reversed sequence of onset of phobia symptoms before that of the infections included. CONCLUSION Social phobia was the only early anxiety disorder to show an association with a delayed onset of common viral childhood diseases.
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Affiliation(s)
- Vladeta Ajdacic-Gross
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zürich, Zürich, Switzerland; Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Zürich, Switzerland
| | - Aleksandra Aleksandrowicz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zürich , Zürich , Switzerland
| | - Stephanie Rodgers
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zürich , Zürich , Switzerland
| | - Mario Müller
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zürich , Zürich , Switzerland
| | - Wolfram Kawohl
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zürich , Zürich , Switzerland
| | - Wulf Rössler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zürich, Zürich, Switzerland; Collegium Helveticum, Swiss Federal Institute of Technology, University of Zürich, Zürich, Switzerland; Institute of Psychiatry, Laboratory of Neuroscience (LIM27), University of Sao Paulo, Sao Paulo, Brazil
| | - Enrique Castelao
- Department of Psychiatry, University Hospital of Lausanne , Lausanne , Switzerland
| | - Caroline Vandeleur
- Department of Psychiatry, University Hospital of Lausanne , Lausanne , Switzerland
| | - Roland von Känel
- Department of Neurology, Bern University Hospital, Clinic Barmelweid , Barmelweid , Switzerland
| | - Margot Mutsch
- Epidemiology, Biostatistics and Prevention Institute, University of Zürich , Zürich , Switzerland
| | - Roselind Lieb
- Department of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel , Basel , Switzerland
| | - Martin Preisig
- Department of Psychiatry, University Hospital of Lausanne , Lausanne , Switzerland
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15
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Abstract
"Children are not little adults," and while this is a well-worn aphorism, it is especially true in the context of infection, where the same organism may evoke a different immune response in the pediatric central nervous system (CNS) and clinical presentation may be clouded by the lack of a good history or paucity of clinical information. The chronology and natural history of different organisms/infections will be laid out together with the preferred use of different imaging modalities. This chapter will use illustrative examples of some of the more common infections and their complications, in addition to several more rare conditions as well as mimics of childhood CNS infection. Challenges in the imaging of children, including strategies to minimize the use of radiation, are discussed. Some of the more recently voiced concerns regarding the use of anesthetic agents in children are also addressed, along with the contrast agents that are typically required for imaging. With a global increase in worldwide travel the anticipation is that pediatricians will increasingly see unusual organisms presenting with CNS infection while dealing with the ever-present risk of drug resistance with inappropriately treated common or garden infections.
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Affiliation(s)
- Jill V Hunter
- Department of Pediatric Radiology, Texas Children's Hospital and Baylor College of Medicine, Houston, TX, USA.
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16
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Haßler A, Porto L, Lehrnbecher T. Cerebral Fungal Infection in Pediatric Cancer Patients. CURRENT FUNGAL INFECTION REPORTS 2015. [DOI: 10.1007/s12281-014-0213-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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18
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Orman G, Benson JE, Kweldam CF, Bosemani T, Tekes A, de Jong MR, Seyfert D, Northington FJ, Poretti A, Huisman TAGM. Neonatal Head Ultrasonography Today: A Powerful Imaging Tool! J Neuroimaging 2014; 25:31-55. [DOI: 10.1111/jon.12108] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Revised: 09/06/2013] [Accepted: 09/15/2013] [Indexed: 11/27/2022] Open
Affiliation(s)
- Gunes Orman
- 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
| | - Jane E. Benson
- 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
| | - Charlotte F. Kweldam
- 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
| | - Thangamadhan Bosemani
- 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
- Neurosciences Intensive Care Nursery Program; The Johns Hopkins University School of Medicine; Baltimore MD
| | - Aylin Tekes
- 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
- Neurosciences Intensive Care Nursery Program; The Johns Hopkins University School of Medicine; Baltimore MD
| | - M. Robert de Jong
- 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
| | - Donna Seyfert
- 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
| | - Frances J. Northington
- Neurosciences Intensive Care Nursery Program; The Johns Hopkins University School of Medicine; Baltimore MD
- Division of Neonatology; Department of Pediatrics; The Johns Hopkins University School of Medicine; Baltimore MD
| | - Andrea Poretti
- 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
- Neurosciences Intensive Care Nursery Program; The Johns Hopkins University School of Medicine; Baltimore MD
| | - Thierry A. G. M. Huisman
- 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
- Neurosciences Intensive Care Nursery Program; The Johns Hopkins University School of Medicine; Baltimore MD
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19
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Bosemani T, Poretti A, Huisman TA. Susceptibility-weighted imaging in pediatric neuroimaging. J Magn Reson Imaging 2013; 40:530-44. [DOI: 10.1002/jmri.24410] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 08/22/2013] [Indexed: 11/10/2022] Open
Affiliation(s)
- Thangamadhan Bosemani
- 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
| | - Andrea Poretti
- 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
| | - Thierry A.G.M. Huisman
- 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
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20
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Celzo FG, Venstermans C, De Belder F, Van Goethem J, van den Hauwe L, van der Zijden T, Voormolen M, Menovsky T, Maas A, Parizel PM. Brain stones revisited-between a rock and a hard place. Insights Imaging 2013; 4:625-635. [PMID: 24022617 PMCID: PMC3781244 DOI: 10.1007/s13244-013-0279-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Accepted: 07/31/2013] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES AND METHODS Large intracranial calcifications are occasionally encountered in routine computed tomography (CT) scans of the brain. These calcifications, also known as "brain stones", can be classified according to location and aetiology. Combining imaging findings with relevant clinical history and physical examination can help narrow down the differential diagnosis and may allow confident diagnosis in certain situations. RESULTS This article provides a pictorial review illustrating various clinical entities resulting in brain stones. DISCUSSION Based on location, brain stones can be classified as extra- or intra-axial. Extra-axial brain stones comprise tumours and exaggerated physiological calcifications. Intra-axial brain stones can further be classified according to aetiology, namely neoplastic, vascular, infectious, congenital and endocrine/metabolic. Imaging findings combined with essential clinical information can help in narrowing the differential diagnosis, determining disease state and evaluating effect of therapy. TEACHING POINTS • Based on location, brain stones can be either extra- or intra-axial. • Extra-axial brain stones comprise tumours and exaggerated physiological calcifications. • Intra-axial aetiologies include neoplastic, vascular, infectious, congenital and endocrine/metabolic. • CT scan is the mainstay in identifying and characterising brain stones. • Certain MRI sequences (gradient echo T2* and susceptibility-weighted imaging) are considered adjunctive.
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Affiliation(s)
- Froilan G Celzo
- Department of Radiology, Antwerp University Hospital, University of Antwerp, Wilrijkstraat 10, 2650, Edegem, Belgium,
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21
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Gurion R, Nwankwo C, Nanda K, Brooks EB, Mitchell AL, Wiznitzer M, Robinson AB. A 4-Year-Old Amish Boy With Weakness, Arthritis, Rash, Verbal Delay, and Failure to Thrive. Arthritis Care Res (Hoboken) 2013; 65:1539-47. [DOI: 10.1002/acr.22019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2012] [Accepted: 03/20/2013] [Indexed: 11/09/2022]
Affiliation(s)
- Reut Gurion
- Cleveland Case Medical Center and Rainbow Babies & Children's Hospital; Cleveland; Ohio
| | - Chinasa Nwankwo
- Cleveland Case Medical Center and Rainbow Babies & Children's Hospital; Cleveland; Ohio
| | - Kabita Nanda
- Seattle Children's Hospital; Seattle; Washington
| | - Elizabeth B. Brooks
- Cleveland Case Medical Center and Rainbow Babies & Children's Hospital; Cleveland; Ohio
| | - Anna L. Mitchell
- Cleveland Case Medical Center and Rainbow Babies & Children's Hospital; Cleveland; Ohio
| | - Max Wiznitzer
- Cleveland Case Medical Center and Rainbow Babies & Children's Hospital; Cleveland; Ohio
| | - Angela B. Robinson
- Cleveland Case Medical Center and Rainbow Babies & Children's Hospital; Cleveland; Ohio
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22
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Poretti A, Valk J, Huisman TAGM. A neuroimaging pattern-recognition approach in pediatric intracranial calcifications. Dev Med Child Neurol 2013; 55:7-8. [PMID: 23116169 DOI: 10.1111/j.1469-8749.2012.04439.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Andrea Poretti
- Division of Pediatric Radiology, Russell H Morgan Department of Radiology and Radiological Science, The Johns Hopkins School of Medicine, Baltimore, MD, USA
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