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Garzon JP, Pardo AC, Raski CR, Prada CE. Dandy-Walker malformation in an individual with ABL1 variant. Am J Med Genet A 2024:e63718. [PMID: 38760987 DOI: 10.1002/ajmg.a.63718] [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: 03/22/2024] [Revised: 04/30/2024] [Accepted: 05/07/2024] [Indexed: 05/20/2024]
Abstract
Dandy-Walker malformation (DWM) is often sporadic, but there are a growing number of genetic disorders that have been associated with this condition. We present a female individual with a de novo variant in ABL1, c.734A>G (p.Y245), who was diagnosed prenatally with DWM. ABL1-related neurodevelopmental disorder was recently identified but brain malformations have not been well characterized to date. We reviewed the published literature and identified one additional individual with DWM and ABL1-related disorder, which suggests a possible association with this malformation.
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Affiliation(s)
- Jenny P Garzon
- Division of Genetics, Genomics, and Metabolism, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Andrea C Pardo
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Division of Neurology, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Carolyn R Raski
- Division of Genetics, Genomics, and Metabolism, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Carlos E Prada
- Division of Genetics, Genomics, and Metabolism, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Alsehli H, Alshahrani SM, Alzahrani S, Ababneh F, Alharbi NM, Alarfaj N, Baarmah D. Fetal and neonatal outcomes of posterior fossa anomalies: a retrospective cohort study. Sci Rep 2024; 14:8411. [PMID: 38600369 PMCID: PMC11006671 DOI: 10.1038/s41598-024-59163-8] [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: 11/30/2023] [Accepted: 04/08/2024] [Indexed: 04/12/2024] Open
Abstract
The primary aim of this study was to estimate the incidence of posterior fossa anomalies (PFA) and assess the associated outcomes in King Abdulaziz Medical City (KAMC), Riyadh. All fetuses diagnosed by prenatal ultrasound with PFA from 2017 to 2021 in KAMC were analyzed retrospectively. PFA included Dandy-Walker malformation (DWM), mega cisterna magna (MCM), Blake's pouch cyst (BPC), and isolated vermian hypoplasia (VH). The 65 cases of PFA were 41.5% DWM, 46.2% MCM, 10.8% VH, and 1.5% BPC. The annual incidence rates were 2.48, 2.64, 4.41, 8.75, and 1.71 per 1000 anatomy scans for 2017, 2018, 2019, 2020, and 2021, respectively. Infants with DWM appeared to have a higher proportion of associated central nervous system (CNS) abnormalities (70.4% vs. 39.5%; p-value = 0.014) and seizures than others (45% vs. 17.9%; p-value = 0.041). Ten patients with abnormal genetic testing showed a single gene mutation causing CNS abnormalities, including a pathogenic variant in MPL, C5orf42, ISPD, PDHA1, PNPLA8, JAM3, COL18A1, and a variant of uncertain significance in the PNPLA8 gene. Our result showed that the most common PFA is DWM and MCM. The autosomal recessive pathogenic mutation is the major cause of genetic disease in Saudi patients diagnosed with PFA.
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Affiliation(s)
- Hanan Alsehli
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
- Department of Obstetrics and Gynecology, King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia.
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
| | - Saeed Mastour Alshahrani
- Department of Public Health, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Shatha Alzahrani
- Department of Pediatric Neurology, King Abdullah Specialist Children Hospital, Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Farouq Ababneh
- Department of Genetics and Precision Medicine, King Abdullah Specialist Children Hospital, Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
- King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Nawal Mashni Alharbi
- Department of Obstetrics and Gynecology, King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Nassebah Alarfaj
- Department of Obstetrics and Gynecology, King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Duaa Baarmah
- Department of Pediatrics, King Abdullah Bin Abdulaziz University Hospital, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
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Zhi Y, Liu L, Cui S, Li Y, Chen X, Che J, Han X, Zhao L. Pathogenic/likely pathogenic copy number variations and regions of homozygosity in fetal central nervous system malformations. Arch Gynecol Obstet 2023; 308:1723-1735. [PMID: 36464758 DOI: 10.1007/s00404-022-06866-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 11/11/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To explore pathogenic/likely pathogenic copy number variations (P/LP CNVs) and regions of homozygosity (ROHs) in fetal central nervous system (CNS) malformations. METHODS A cohort of 539 fetuses with CNS malformations diagnosed by ultrasound/MRI was retrospectively analyzed between January 2016 and December 2019. All fetuses were analyzed by chromosomal microarray analysis (CMA). Three cases with ROHs detected by CMA were subjected to whole-exome sequencing (WES). The fetuses were divided into two groups according to whether they had other structural abnormalities. The CNS phenotypes of the two groups were further classified as simple (one type) or complicated (≥ 2 types). RESULTS (1) A total of 35 cases with P/LP CNVs were found. The incidence of P/LP CNVs was higher in the extra-CNS group [18.00% (9/50)] than in the isolated group [5.32% (26/489)] (P < 0.01), while there was no significant difference between the simpletype and complicated-type groups. (2) In the simple-type group, the three most common P/LP CNV phenotypes were holoprosencephaly, Dandy-Walker syndrome, and exencephaly. There were no P/LP CNVs associated with anencephaly, microcephaly, arachnoid cysts, ependymal cysts, or intracranial hemorrhage. (3) Only four cases with ROHs were found, and there were no cases of uniparental disomy or autosomal diseases. CONCLUSION The P/LP CNV detection rates varied significantly among the different phenotypes of CNS malformations, although simple CNS abnormalities may also be associated with genetic abnormalities.
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Affiliation(s)
- Yunxiao Zhi
- Department of the Third Hospital of Zhengzhou University, Zhengzhou, 450000, Henan, China
| | - Ling Liu
- Department of the Third Hospital of Zhengzhou University, Zhengzhou, 450000, Henan, China
| | - Shihong Cui
- Department of the Third Hospital of Zhengzhou University, Zhengzhou, 450000, Henan, China.
| | - Ying Li
- Department of the Third Hospital of Zhengzhou University, Zhengzhou, 450000, Henan, China
| | - Xiaolin Chen
- Department of the Third Hospital of Zhengzhou University, Zhengzhou, 450000, Henan, China
| | - Jia Che
- Department of the Third Hospital of Zhengzhou University, Zhengzhou, 450000, Henan, China
| | - Xiao Han
- Department of the Third Hospital of Zhengzhou University, Zhengzhou, 450000, Henan, China
| | - Lanlan Zhao
- Department of the Third Hospital of Zhengzhou University, Zhengzhou, 450000, Henan, China
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Sun Y, Wang T, Zhang N, Zhang P, Li Y. Clinical features and genetic analysis of Dandy-Walker syndrome. BMC Pregnancy Childbirth 2023; 23:40. [PMID: 36653756 PMCID: PMC9847126 DOI: 10.1186/s12884-023-05367-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 01/10/2023] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Dandy-Walker syndrome (DWS) is a rare congenital malformation of the central nervous system (CNS), characterized by underdevelopment or dysplasia of the cerebellar vermis, expansion of the fourth ventricle and posterior fossa cistern. The incidence is aboutapproximately 1/25000-1/35000. At present, the etiology and pathogenesis of DWS are not completely clear. It is mostly considered to be a multifactorial genetic disease that is related to both genetic factors and environmental factors. There is no large sample size analysis of the chromosomal profile of DWS up to now. This study aims to provide clinical reference for prenatal diagnosis via summarizing the clinical features and pregnancy outcomes of Dandy-Walker syndrome. METHODS A total of 76 cases of foetal Dandy-Walker syndrome out of 19,506 pregnant women underwent cordocentesis or amniocentesis for genetic detection. Rapid prenatal karyotyping, single nucleotide polymorphism array (SNP-array) and BACs-on-Beads™ (BoBs) were performed for prenatal genetic diagnosis. The results of ultrasonography, genetic analysis and pregnancy outcome were recorded. RESULTS Of the 76 cases, 19 were isolated DWS, while 57 cases were accompanied by other ultrasound-visible abnormalities. Ultrasound abnormalities of the CNS were most frequently observed, accompanied by DWS. Twenty-five out of 76 cases had chromosomal abnormalities, and the rate of chromosomal abnormalities increased in pregnant women of advanced maternal age or in combination with other ultrasound abnormalities. Of the 19 cases in the isolated DWS group, nine pregnant women chose to terminate the pregnancy, while seven cases continued the pregnancy and all infants were normal. Among the 57 pregnant women with pathological ultrasound manifestations other than foetal DWS, 44 chose to terminate the pregnancy, while 12 cases continued the pregnancy. Further follow-up revealed one newborn with postnatal neurodevelopmental delay. A female term neonate presented with very severe sensorineural deafness, and an infant died 7 days after birth with abnormal development of multiple organs. CONCLUSIONS Pregnant women with DWS in foetal ultrasonic examination should be offered a careful and comprehensive foetal ultrasound scan and further prenatal genetic testing including karyotype analysis and SNP-array. The prognosis of the foetus without chromosomal aberration is good in isolated DWS pregnancies but poor in nonisolated DWS pregnancies.
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Affiliation(s)
- Yanmei Sun
- grid.440208.a0000 0004 1757 9805Department of Reproductive Genetics, Hebei General Hospital, Shijiazhuang, 050051 China
| | - Tao Wang
- grid.415912.a0000 0004 4903 149XThe Second People’s Hospital of Liaocheng, Liaocheng, 252600 China
| | - Ning Zhang
- grid.440208.a0000 0004 1757 9805Department of Reproductive Genetics, Hebei General Hospital, Shijiazhuang, 050051 China
| | - Pingping Zhang
- grid.440208.a0000 0004 1757 9805Department of Reproductive Genetics, Hebei General Hospital, Shijiazhuang, 050051 China
| | - Yali Li
- grid.440208.a0000 0004 1757 9805Department of Reproductive Genetics, Hebei General Hospital, Shijiazhuang, 050051 China
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A rare association of Down syndrome with Dandy –Walker variant, pulmonary hypertension and childhood interstitial lung disease: A case report of a prognostic dilemma. J Taibah Univ Med Sci 2022; 17:950-953. [PMID: 36212578 PMCID: PMC9519608 DOI: 10.1016/j.jtumed.2022.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 03/18/2022] [Accepted: 05/25/2022] [Indexed: 11/22/2022] Open
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Luo TF, Wang YB, Wang DH, Zhan S, Deng SL. Lateral ventricle pleomorphic xanthoastrocytoma concurrent with Dandy-Walker complex: A case report. Medicine (Baltimore) 2022; 101:e30492. [PMID: 36086683 PMCID: PMC10980463 DOI: 10.1097/md.0000000000030492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/03/2022] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Dandy-Walker complex and pleomorphic xanthoastrocytomas are both rare disease entities that typically manifest early in life and are associated with congenital etiological factors. Dandy-Walker complex is a cerebellar malformation associated with a series of anatomical changes. The disease onset is usually at birth or during infancy. Late onset in adulthood is uncommon. Pleomorphic xanthoastrocytoma is a rare WHO grade II astrocytic tumor affecting mainly young adults. Concomitant occurrence of Dandy-Walker complex and pleomorphic xanthoastrocytoma has not been previously reported. PATIENT CONCERNS AND DIAGNOSIS A 30-year-old woman with a previous history of unconfirmed resected lateral ventricle meningioma presented with severe headache for 1 day. Imaging examination revealed a mass in the right lateral ventricle with heterogeneous signal patterns, changes in the posterior fossa corresponding to a Dandy-Walker variant, and mild hydrocephalus. INTERVENTIONS AND OUTCOMES Surgical complete resection of the mass was achieved. postoperative histopathological examination confirmed WHO grade II pleomorphic xanthoastrocytoma. Three years postsurgery, ventriculoperitoneal shunt was performed due to worsening of hydrocephalus. The patient has since remained symptom-free. CONCLUSION This is the first report of concomitant occurrence of Dandy-Walker complex and pleomorphic xanthoastrocytoma. The association of neurological congenital malformation with intracranial neoplasms may be multifactorial, with underlying role of genetic mutations or chromosome alterations.
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Affiliation(s)
- Tian-Fei Luo
- Department of Neurology, First Hospital of Jilin University, Chang Chun, China
| | - Yu-Bo Wang
- Department of Oncological Neurosurgery, First Hospital of Jilin University, Chang Chun, China
| | - Dan-Hua Wang
- Department of Pathology, First Hospital of Jilin University, Chang Chun, China
| | - Shuang Zhan
- Department of Oncological Neurosurgery, First Hospital of Jilin University, Chang Chun, China
| | - Shuang-Lin Deng
- Department of Oncological Neurosurgery, First Hospital of Jilin University, Chang Chun, China
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Huang J, Saint-Martin C, Tchakarska G, Lavoie J, Myers KA. Cerebral white matter abnormalities associated with chromosome 18q duplication. Brain Dev 2022; 44:562-566. [PMID: 35469635 DOI: 10.1016/j.braindev.2022.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/18/2022] [Accepted: 04/10/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Chromosome 18q duplications are associated with a range of phenotypes often similar to complete trisomy 18, variably including poor growth, feeding difficulties, congenital malformations and dysmorphic facial features. Although 18q duplication patients may have seizures and developmental impairment, brain MRI typically shows only variable degrees of cerebral atrophy. PATIENT We present a boy with a 52.2 Mb 18q duplication in whom brain MRI in the neonatal period showed striking white matter abnormalities, most notable in the frontal lobes. His clinical presentation was otherwise in keeping with trisomy 18, including characteristic facial features, hypotonia, cardiac malformation, rocker bottom feet, pectus excavatum, short and broad thumbs and halluces, and diabetes insipidus. CONCLUSION Since not previously reported in association with 18q duplication, the observation of cerebral white matter anomalies is particularly interesting. This radiologic pattern is a well-recognized feature of 18q deletion syndrome, hypothesized by many to occur due to haploinsufficiency of MBP, the gene encoding myelin basic protein. The mechanisms leading to the white matter anomalies in this patient remain unexplained.
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Affiliation(s)
- Jiayin Huang
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Christine Saint-Martin
- Department of Medical Imaging, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
| | - Guergana Tchakarska
- McGill University Health Centre, Montreal, Quebec, Canada; Department of Human Genetics, McGill University, Montreal, Quebec, Canada
| | - Josée Lavoie
- Department of Human Genetics, McGill University, Montreal, Quebec, Canada; Department of Pathology, McGill University, Montreal, Quebec, Canada
| | - Kenneth A Myers
- Research Institute of the McGill University Medical Centre, Montreal, Quebec, Canada; Division of Neurology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada; Department of Neurology and Neurosurgery, McGill University Health Centre, Montreal, Quebec, Canada.
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Congenital Brain Malformations: An Integrated Diagnostic Approach. Semin Pediatr Neurol 2022; 42:100973. [PMID: 35868725 DOI: 10.1016/j.spen.2022.100973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 04/11/2022] [Accepted: 04/13/2022] [Indexed: 11/24/2022]
Abstract
Congenital brain malformations are abnormalities present at birth that can result from developmental disruptions at various embryonic or fetal stages. The clinical presentation is nonspecific and can include developmental delay, hypotonia, and/or epilepsy. An informed combination of imaging and genetic testing enables early and accurate diagnosis and management planning. In this article, we provide a streamlined approach to radiologic phenotyping and genetic evaluation of brain malformations. We will review the clinical workflow for brain imaging and genetic testing with up-to-date ontologies and literature references. The organization of this article introduces a streamlined approach for imaging-based etiologic classification into malformative, destructive, and migrational abnormalities. Specific radiologic ontologies are then discussed in detail, with correlation of key neuroimaging features to embryology and molecular pathogenesis.
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Qurban Q, Kamil Z, Tebha SS, Zaidi ZA, Said M, Zehra SF, Ali S, Sethar S. Ocular manifestations in a patient with Dandy-Walker malformation: A case report. Radiol Case Rep 2021; 17:812-815. [PMID: 35024082 PMCID: PMC8733037 DOI: 10.1016/j.radcr.2021.12.027] [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: 11/12/2021] [Revised: 12/03/2021] [Accepted: 12/13/2021] [Indexed: 12/03/2022] Open
Abstract
We present a unique case of a ten-month-old boy with a protruding left globe and vitreous haemorrhaging, and later being diagnosed as a case of a dandy-walker syndrome (DWS) with buphthalmos and vitreous haemorrhage. Treatment is depending on the symptoms reported, thus close monitoring and a multidisciplinary approach are essential. We would like to recommend that even if there are no cardinal symptoms of DWS, paediatric patients with ocular signs should have Dandy walker Malformation (DWM) considered as a differential diagnosis.
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Affiliation(s)
- Qirat Qurban
- Department of Ophthalmology, Jinnah Medical and Dental College, Karachi, Pakistan
| | - Zeeshan Kamil
- Department of Ophthalmology, Jinnah Medical and Dental College, Karachi, Pakistan
| | - Sameer Saleem Tebha
- Department of Neurosurgery and Neurology , Jinnah Medical and Dental College, Karachi, Pakistan
| | - Zain Ali Zaidi
- Department of Medicine and Allied, Jinnah Medical and Dental College, Karachi, Pakistan
| | - Maahirah Said
- Department of Medicine, Ziauddin University, Karachi, Pakistan
| | - Samar Fatima Zehra
- Department of Medicine, Jinnah Medical and Dental College, Karachi, Pakistan
| | - Sajjad Ali
- Department of Medicine, Ziauddin Medical University, Karachi, Pakistan,Corresponding Author.
| | - Sehrish Sethar
- Department of Radiology, Jinnah Medical and Dental College, Karachi, Pakistan
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Alshami A, Douedi S, Guida M, Ajam F, Desai D, Zales V, Calderon DM. Unusual Longevity of Edwards Syndrome: A Case Report. Genes (Basel) 2020; 11:genes11121466. [PMID: 33297534 PMCID: PMC7762407 DOI: 10.3390/genes11121466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 11/29/2020] [Accepted: 12/04/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Trisomy 18, also known as Edwards syndrome, was first described in the 1960s and is now defined as the second most common trisomy. While this genetic disease has been attributed to nondisjunction during meiosis, the exact mechanism remains unknown. Trisomy 18 is associated with a significantly increased mortality rate of about 5-10% of patients surviving until 1 year of age. We present a case of a 26-year-old female diagnosed with trisomy 18, well outliving her life expectancy, maintaining a stable state of health. CASE PRESENTATION A 26-year-old female with non-mosaic Edwards syndrome presented to the clinic for follow up after recent hospitalization for aspiration pneumonia. The definitive diagnosis of trisomy 18 was made prenatally utilizing chromosomal analysis and G-banding and fluorescence in situ hybridization (FISH) on cells obtained via amniocentesis. Her past medical history is characterized by severe growth and intellectual limitations; recurrent history of infections, especially respiratory system infections; and a ventricular septal defect (VSD) that was never surgically repaired. She remains in good, stable health and is under close follow-up and monitoring. CONCLUSIONS Despite the fact that Edwards syndrome carries a significantly high mortality rate due to several comorbidities, recent literature including this case report has identified patients surviving into adulthood. Advancements in early detection and parent education have likely allowed for these findings. We aim to present a case of an adult with trisomy 18, living in stable condition, with an importance on medical follow-up.
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Affiliation(s)
- Abbas Alshami
- Department of Medicine, Jersey Shore University Medical Center, Neptune, NJ 07753, USA;
| | - Steven Douedi
- Department of Medicine, Jersey Shore University Medical Center, Neptune, NJ 07753, USA;
- Correspondence:
| | - Melissa Guida
- Department of Biology, Ramapo College of New Jersey, Mahwah, NJ 07430, USA;
| | - Firas Ajam
- Department of Cardiology, Jersey Shore University Medical Center, Neptune, NJ 07753, USA; (F.A.); (D.D.); (D.MC.)
| | - Dhaval Desai
- Department of Cardiology, Jersey Shore University Medical Center, Neptune, NJ 07753, USA; (F.A.); (D.D.); (D.MC.)
| | - Vincent Zales
- Department of Pediatrics, Jersey Shore University Medical Center, Neptune, NJ 07753, USA;
| | - Dawn M Calderon
- Department of Cardiology, Jersey Shore University Medical Center, Neptune, NJ 07753, USA; (F.A.); (D.D.); (D.MC.)
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Ferreira de Souza LM, Galvão E Brito Medeiros A, Júnior JPR, de Melo AN, Dias SAMM. Long Survival of a Patient with Trisomy 18 and Dandy-Walker Syndrome. ACTA ACUST UNITED AC 2019; 55:medicina55070352. [PMID: 31288482 PMCID: PMC6681329 DOI: 10.3390/medicina55070352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Revised: 07/01/2019] [Accepted: 07/02/2019] [Indexed: 11/16/2022]
Abstract
Trisomy 18 is a genetic disease resulting from an extra chromosome 18, characterized by a broad clinical spectrum, poor prognosis and low rates of survival. This is the case of a 12 year-old girl diagnosed with full trisomy 18, and multiple malformations, including Dandy-Walker Syndrome and congenital heart defects on long term survival. At nine months, a new echocardiogram showed a double outlet right ventricle, significant pulmonary stenosis, patent ductus arteriosus and ventricular septal defect. Cardiac surgery was performed at one year and seven months. Early surgical intervention and multidisciplinary follow-up may change the clinical outcome of the disease. Further studies are required to evaluate the benefit of invasive procedures such as cardiac surgery on survival of patients with trisomy 18.
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Affiliation(s)
| | | | | | - Aurea Nogueira de Melo
- Department of Pediatric of Federal, University of Rio Grande do Norte, Natal 58051-900, Brazil.
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Dasgupta K, Jeong J. Developmental biology of the meninges. Genesis 2019; 57:e23288. [PMID: 30801905 DOI: 10.1002/dvg.23288] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 02/20/2019] [Accepted: 02/21/2019] [Indexed: 01/14/2023]
Abstract
The meninges are membranous layers surrounding the central nervous system. In the head, the meninges lie between the brain and the skull, and interact closely with both during development. The cranial meninges originate from a mesenchymal sheath on the surface of the developing brain, called primary meninx, and undergo differentiation into three layers with distinct histological characteristics: the dura mater, the arachnoid mater, and the pia mater. While genetic regulation of meningeal development is still poorly understood, mouse mutants and other models with meningeal defects have demonstrated the importance of the meninges to normal development of the calvaria and the brain. For the calvaria, the interactions with the meninges are necessary for the progression of calvarial osteogenesis during early development. In later stages, the meninges control the patterning of the skull and the fate of the sutures. For the brain, the meninges regulate diverse processes including cell survival, cell migration, generation of neurons from progenitors, and vascularization. Also, the meninges serve as a stem cell niche for the brain in the postnatal life. Given these important roles of the meninges, further investigation into the molecular mechanisms underlying meningeal development can provide novel insights into the coordinated development of the head.
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Affiliation(s)
- Krishnakali Dasgupta
- New York University College of Dentistry, Department of Basic Science and Craniofacial Biology, New York, New York
| | - Juhee Jeong
- New York University College of Dentistry, Department of Basic Science and Craniofacial Biology, New York, New York
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Gao Y, Ma YC, Ju YH, Li YN. Mosaicism trisomy 10 in a 14-month-old child with additional neurological abnormalities: case report and literature review. BMC Pediatr 2018; 18:266. [PMID: 30081864 PMCID: PMC6090700 DOI: 10.1186/s12887-018-1237-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 07/27/2018] [Indexed: 11/10/2022] Open
Abstract
Background Trisomy 10 is very rarely diagnosed, especially in living persons. Most reports of trisomy 10 pertain to prenatal diagnosis of trisomy 10 in the fetus. In addition, trisomy 10 has been reported as part of partial chromosomal abnormalities in some leukemic cells and tumor specimens. Only 6 cases of mosaicism trisomy 10 have been reported so far. None of these reports pertain to living children with neurological abnormalities. Case presentation We report the case of a 14-month-old girl who was brought for treatment of unusual facies, growth retardation, and patent ductus arteriosus. Karyotype analysis revealed a 47, XX, + 10/46, XX pattern. MRI showed characteristics of Dandy–Walker syndrome and ventricular enlargement in the brain. Conclusions This case is distinguished by its extreme rarity and its potential for use as a reference case of this condition in clinical settings.
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Affiliation(s)
- Yang Gao
- Department of Pediatrics, The First Hospital of Jilin University, Changchun, Jilin, 130021, People's Republic of China
| | - Yu-Cong Ma
- Department of Pediatrics, The First Hospital of Jilin University, Changchun, Jilin, 130021, People's Republic of China
| | - Yang-Hua Ju
- Department of Pediatrics, The First Hospital of Jilin University, Changchun, Jilin, 130021, People's Republic of China
| | - Ya-Nan Li
- Department of Pediatrics, The First Hospital of Jilin University, Changchun, Jilin, 130021, People's Republic of China. .,Department of Molecular Biology, Basic Medical College of Jilin University, Changchun, 130021, People's Republic of China.
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Wang TJ, Li YY, Wu WJ, Lin CK, Wang CK, Wang CY, Hwang KS, Su HY. Dandy-Walker syndrome with duplex kidney abnormalities in trisomy 18 - A rare case report. Taiwan J Obstet Gynecol 2018; 56:697-699. [PMID: 29037562 DOI: 10.1016/j.tjog.2017.08.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2017] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE Trisomy 18 is one of the major numerical chromosomal disorders. The incidence of trisomy 18 is approximately one in 6000 live births. Dandy-Walker malformation (DWM) is the most common congenital malformation of the cerebellum, with an incidence of about one in 5000 live births. The incidence of trisomy 18 associated with DWM is rare and long-term survival rate is very low. CASE REPORT A case involving a 39-year-old pregnant female with a case of trisomy 18 associated with DWM. CONCLUSION The incidence of trisomy 18 associated with DWM is rare, and our report presents an unusual case that supplements our knowledge of this condition. We report a case involving a 39-year-old pregnant female with a case of trisomy 18 associated with Dandy-Walker malformation (DWM). Fetal ultrasonography showed hypoplasia of the cerebellar vermis and dilatation of the fourth ventricle and was characterized by an enlarged posterior fossa. Fetal magnetic resonance imaging showed inferior vermian hypoplasia and a large posterior fossa cyst communicating with the fourth ventricle causing high insertion of the torcular herophili, which was compatible with DWM. Furthermore, the karyotyping report revealed trisomy 18. The incidence of trisomy 18 associated with DWM is rare, and our report presents an unusual case that supplements our knowledge of this condition.
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Affiliation(s)
- Tun-Jun Wang
- Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yi-Ying Li
- Taiji Fetal Medicine Center, Taipei, Taiwan
| | - Wan-Ju Wu
- Taiji Fetal Medicine Center, Taipei, Taiwan
| | - Chi-Kang Lin
- Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chun-Kai Wang
- Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chen-Yu Wang
- Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Kwei-Shuai Hwang
- Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Her-Young Su
- Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
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Dandy-Walker Syndrome: A Review of New Diagnosis and Management in Children. JOURNAL OF PEDIATRICS REVIEW 2018. [DOI: 10.5812/jpr.63486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Stambolliu E, Ioakeim-Ioannidou M, Kontokostas K, Dakoutrou M, Kousoulis AA. The Most Common Comorbidities in Dandy-Walker Syndrome Patients: A Systematic Review of Case Reports. J Child Neurol 2017. [PMID: 28635420 DOI: 10.1177/0883073817712589] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Dandy-Walker syndrome (DWS) is a rare neurologic multi-entity malformation. This review aimed at reporting its main nonneurologic comorbidities. METHODS Following PRISMA guidelines, search in Medline was conducted (2000-2014, keyword: dandy-walker). Age, sex, country, DWS type, consanguinity or siblings with DWS, and recorded coexistent conditions (by ICD10 category) were extracted for 187 patients (46.5% male, 43% from Asia) from 168 case reports. RESULTS Diagnosis was most often set in <1 year old (40.6%) or >12 years old (27.8%). One-third of cases had a chromosomal abnormality or syndrome (n = 8 PHACE), 27% had a cardiovascular condition (n = 7 Patent Ductus Arteriosus), 24% had a disease of eye and ear (n = 9 cataract); most common malignancy was nephroblastoma (n = 8, all Asian). Almost one-fifth had a mental illness diagnosis; only 6.4% had mild or severe intellectual disability. CONCLUSION The spread of comorbidities calls for early diagnosis and multidisciplinary research and practice, especially as many cases remain clinically asymptomatic for years.
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Affiliation(s)
- Emelina Stambolliu
- 1 Society of Junior Doctors, Athens, Greece.,2 Department of Internal Medicine, General Hospital of Kalavryta, Kalavryta, Greece
| | | | | | - Maria Dakoutrou
- 1 Society of Junior Doctors, Athens, Greece.,5 First Department of Paediatrics, "Aghia Sophia" Children's Hospital, University of Athens, Greece
| | - Antonis A Kousoulis
- 1 Society of Junior Doctors, Athens, Greece.,6 Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
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Gaffney RE, Fisher KL. Dandy-Walker Malformation With Concomitant Agenesis of the Corpus Callosum as Investigated by Neonatal Sonography. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2017. [DOI: 10.1177/8756479317697276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Dandy-Walker malformation and agenesis of the corpus callosum, although uncommon among all births, are commonly seen in association with one another due to the malformations’ effects on the central nervous system. Obstetric sonographers are likely familiar with the typical appearance of these abnormalities in utero, as sonography is routinely used to detect such congenital anomalies prenatally. However, sonography also plays a valuable role in the postnatal follow-up evaluation of the brain and other body systems affected by Dandy-Walker malformation and its associated abnormalities, thus making it imperative for all sonographers to be familiar with their postnatal sonographic appearance. The case presented demonstrates the use of neonatal sonography to evaluate and follow a case of Dandy-Walker malformation with associated agenesis of the corpus callosum that was originally diagnosed by prenatal sonography. The purpose of this case study is to highlight the pathologies and their coexistence, demonstrate their neonatal sonographic characteristics, exhibit corresponding magnetic resonance imaging appearance, and provide guidance for future patient cases.
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Affiliation(s)
- Rachel E. Gaffney
- Diagnostic Medical Ultrasound Program, University of Missouri, Columbia, MO, USA
| | - Kelsy L. Fisher
- Diagnostic Medical Ultrasound Program, University of Missouri, Columbia, MO, USA
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Dawra RD, Karia S, Shah N, Desousa A. Psychosis in a Case of Dandy-Walker Syndrome: A Case Report. J Clin Diagn Res 2017; 11:VD03-VD04. [PMID: 28658885 DOI: 10.7860/jcdr/2017/25040.9861] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 03/03/2017] [Indexed: 11/24/2022]
Abstract
Dandy Walker Syndrome (DWS) is a congenital malformation with brain abnormalities, intellectual disabilities, epilepsy and visible structural changes in particular brain structures. We present here a case of psychosis in an 18-year-old male with DWS, epilepsy and intellectual disability. The purpose of this paper is to discuss the clinically relevant issues, psychopharmacological issues, neuropsychiatric manifestations and consultation liaison issues involved.
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Affiliation(s)
- Ripu Daman Dawra
- Resident, Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India
| | - Sagar Karia
- Medical Officer, Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India
| | - Nilesh Shah
- Professor and Head, Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India
| | - Avinash Desousa
- Research Associate, Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India
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21
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Samson M, Claassen DO. Neurodegeneration and the Cerebellum. NEURODEGENER DIS 2017; 17:155-165. [DOI: 10.1159/000460818] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 02/06/2017] [Indexed: 12/27/2022] Open
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22
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Wüest A, Surbek D, Wiest R, Weisstanner C, Bonel H, Steinlin M, Raio L, Tutschek B. Enlarged posterior fossa on prenatal imaging: differential diagnosis, associated anomalies and postnatal outcome. Acta Obstet Gynecol Scand 2017; 96:837-843. [DOI: 10.1111/aogs.13131] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2016] [Accepted: 03/07/2017] [Indexed: 12/11/2022]
Affiliation(s)
- Anja Wüest
- Department of Obstetrics and Gynecology; Inselspital; University of Bern; Bern Switzerland
| | - Daniel Surbek
- Department of Obstetrics and Gynecology; Inselspital; University of Bern; Bern Switzerland
| | - Roland Wiest
- Institute of Diagnostic and Interventional Neuroradiology; Inselspital; University of Bern; Bern Switzerland
| | - Christian Weisstanner
- Institute of Diagnostic and Interventional Neuroradiology; Inselspital; University of Bern; Bern Switzerland
| | - Harald Bonel
- Institute of Diagnostic and Interventional Neuroradiology; Inselspital; University of Bern; Bern Switzerland
| | - Maja Steinlin
- Division of Pediatric Neurology; Inselspital; University of Bern; Bern Switzerland
| | - Luigi Raio
- Department of Obstetrics and Gynecology; Inselspital; University of Bern; Bern Switzerland
| | - Boris Tutschek
- Prenatal Zürich; Zürich Switzerland
- Medical Faculty; Heinrich Heine University; Düsseldorf Germany
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Imataka G, Suzumura H, Arisaka O. Clinical features and survival in individuals with trisomy 18: A retrospective one-center study of 44 patients who received intensive care treatments. Mol Med Rep 2016; 13:2457-66. [PMID: 26820816 PMCID: PMC4768975 DOI: 10.3892/mmr.2016.4806] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 01/21/2016] [Indexed: 11/05/2022] Open
Abstract
Trisomy 18 syndrome is a common autosomal aneuploidy chromosomal abnormality caused by the presence of extra chromosome 18 that leads to malformations of various parts of the body. In this study, we retrospectively investigated the effect of the medical progression and prognosis of 44 cases of trisomy 18, admitted to our neonatal intensive care unit between 1992 and 2013. The patients were divided into group A (n=20, 1992‑2002) and group B (n=24, 2003‑2012). Following delivery, karyotype, gender, gestational weeks, birth place, cesarean section, Apgar score and birth weight were analyzed using the Fisher's exact test, unpaired t‑test and Mann‑Whitney U test. Based on the statistical results, a comparison was made of the two groups and no significant differences were observed. Clinical data of major complications, mechanical ventilation, discharge from hospital and survival days were reviewed for the cases of trisomy 18. Of the 44 patients, 42 had cardiac anomaly, 16 had esophageal atresia, and 3 patients had brain anomaly. Ventilation treatment was performed in 29 cases (65.9%) and an increased percentage was identified in group B patients. The percentage survival was estimated using Kaplan‑Meier curves and the two groups were analyzed using the generalized Wilcoxon test. Improvement in life prognosis was observed in group B as compared to group A. The log‑rank test was used to assess survey periods of 180 days, 1 year, and the entire observation period. Although significant differences were observed for the prognosis of trisomy 18 at 180 days after birth, after 1 year and the entire survey period after birth, the significant differences were not confirmed. In conclusion, results of the present study provide information concerning genetic counseling for parents/guardians and life prognosis, prior to applying intensive management to newborns with trisomy 18.
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Affiliation(s)
- George Imataka
- Department of Pediatrics, Dokkyo Medical University School of Medicine, Shimotsuga, Tocihgi 321‑0293, Japan
| | - Hiroshi Suzumura
- Department of Pediatrics, Dokkyo Medical University School of Medicine, Shimotsuga, Tocihgi 321‑0293, Japan
| | - Osamu Arisaka
- Department of Pediatrics, Dokkyo Medical University School of Medicine, Shimotsuga, Tocihgi 321‑0293, Japan
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Cotes C, Bonfante E, Lazor J, Jadhav S, Caldas M, Swischuk L, Riascos R. Congenital basis of posterior fossa anomalies. Neuroradiol J 2015; 28:238-53. [PMID: 26246090 DOI: 10.1177/1971400915576665] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
The classification of posterior fossa congenital anomalies has been a controversial topic. Advances in genetics and imaging have allowed a better understanding of the embryologic development of these abnormalities. A new classification schema correlates the embryologic, morphologic, and genetic bases of these anomalies in order to better distinguish and describe them. Although they provide a better understanding of the clinical aspects and genetics of these disorders, it is crucial for the radiologist to be able to diagnose the congenital posterior fossa anomalies based on their morphology, since neuroimaging is usually the initial step when these disorders are suspected. We divide the most common posterior fossa congenital anomalies into two groups: 1) hindbrain malformations, including diseases with cerebellar or vermian agenesis, aplasia or hypoplasia and cystic posterior fossa anomalies; and 2) cranial vault malformations. In addition, we will review the embryologic development of the posterior fossa and, from the perspective of embryonic development, will describe the imaging appearance of congenital posterior fossa anomalies. Knowledge of the developmental bases of these malformations facilitates detection of the morphological changes identified on imaging, allowing accurate differentiation and diagnosis of congenital posterior fossa anomalies.
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Affiliation(s)
- Claudia Cotes
- Department of Radiology, and Pediatric Radiology, The University of Texas Medical Branch, Galveston, TX, USA
| | - Eliana Bonfante
- Department of Diagnostic and Interventional Imaging, University of Texas Health Science Center at Houston, Houston, TX, USA
| | | | | | | | - Leonard Swischuk
- Department of Radiology, and Pediatric Radiology, The University of Texas Medical Branch, Galveston, TX, USA
| | - Roy Riascos
- Department of Diagnostic and Interventional Imaging, University of Texas Health Science Center at Houston, Houston, TX, USA
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Love K, Huddleston L, Olney P, Wrubel D, Visootsak J. Developmental outcomes of Down syndrome and Dandy-Walker malformation. JOURNAL OF PEDIATRIC NEUROLOGY 2015; 9:405-408. [PMID: 22866020 DOI: 10.3233/jpn-2011-0500] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Dandy-Walker syndrome (DWS), or Dandy-Walker complex, is a congenital brain malformation of the posterior fossa, typically resulting in developmental delay and cognitive disability. The co-occurrence of Down syndrome (DS) and DWS is relatively uncommon; thus, its impact on developmental outcomes has not been fully elucidated. Herein, we report a case of a 37-month-old child with DS and DWS, who is functioning at the following age-equivalent: gross motor at a 9-mo level, fine motor 6 mo, expressive language 14 mo, receptive language 9 mo. As such, it is important to determine how the DWS influences developmental outcomes, and appreciate the importance of early interventional therapy.
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Affiliation(s)
- Kaitlin Love
- Florida State University College of Medicine, Tallahassee, FL, USA
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26
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Reeder MR, Botto LD, Keppler-Noreuil KM, Carey JC, Byrne JLB, Feldkamp ML. Risk factors for Dandy-Walker malformation: A population-based assessment. Am J Med Genet A 2015; 167A:2009-16. [DOI: 10.1002/ajmg.a.37124] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 04/05/2015] [Indexed: 11/10/2022]
Affiliation(s)
- Matthew R. Reeder
- Division of Medical Genetics, Department of Pediatrics; University of Utah School of Medicine; Salt Lake City Utah
| | - Lorenzo D. Botto
- Division of Medical Genetics, Department of Pediatrics; University of Utah School of Medicine; Salt Lake City Utah
| | - Kim M. Keppler-Noreuil
- National Human Genome Research Institute; National Institutes of Health; Bethesda Maryland
| | - John C. Carey
- Division of Medical Genetics, Department of Pediatrics; University of Utah School of Medicine; Salt Lake City Utah
| | - Janice L. B. Byrne
- Division of Medical Genetics, Department of Pediatrics; University of Utah School of Medicine; Salt Lake City Utah
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology; University of Utah School of Medicine; Salt Lake City Utah
| | - Marcia L. Feldkamp
- Division of Medical Genetics, Department of Pediatrics; University of Utah School of Medicine; Salt Lake City Utah
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McClelland S, Ukwuoma OI, Lunos S, Okuyemi KS. Mortality of Dandy-Walker syndrome in the United States: Analysis by race, gender, and insurance status. J Neurosci Rural Pract 2015; 6:182-5. [PMID: 25883477 PMCID: PMC4387808 DOI: 10.4103/0976-3147.153224] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Dandy-Walker syndrome (DWS) is a congenital disorder often diagnosed in early childhood. Typically manifesting with signs/symptoms of increased intracranial pressure, DWS is catastrophic unless timely neurosurgical care can be administered via cerebrospinal fluid (CSF) drainage. The rates of mortality, adverse discharge disposition (ADD), and CSF drainage in DWS may not be uniform regardless of race, gender or insurance status; such differences could reflect disparities in access to neurosurgical care. This study examines these issues on a nationwide level. MATERIALS AND METHODS The Kids' Inpatient Database spanning 1997-2003 was used for analysis. Only patients admitted for DWS (ICD-9-CM = 742.3) were included. Multivariate analysis was adjusted for several variables, including patient age, race, sex, admission type, primary payer, income, and hospital volume. RESULTS More than 14,000 DWS patients were included. Increasing age predicted reduced mortality (OR = 0.87; P < 0.05), ADD (OR = 0.96; P < 0.05), and decreased likelihood of receiving CSF drainage (OR = 0.86; P < 0.0001). Elective admission type predicted reduced mortality (OR = 0.29; P = 0.0008), ADD (OR = 0.68; P < 0.05), and increased CSF drainage (OR = 2.02; P < 0.0001). African-American race (OR = 1.20; P < 0.05) and private insurance (OR = 1.18; P < 0.05) each predicted increased likelihood of receiving CSF drainage, but were not predictors of mortality or ADD. Gender, income, and hospital volume were not significant predictors of DWS outcome. CONCLUSION Increasing age and elective admissions each decrease mortality and ADD associated with DWS. African-American race and private insurance status increase access to CSF drainage. These findings contradict previous literature citing African-American race as a risk factor for mortality in DWS, and emphasize the role of private insurance in obtaining access to potentially lifesaving operative care.
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Affiliation(s)
- Shearwood McClelland
- Program in Health Disparities Research, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Onyinyechi I Ukwuoma
- Department of Pediatrics, Brookdale University Hospital and Medical Center, New York, USA
| | - Scott Lunos
- Biostatistics Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Kolawole S Okuyemi
- Program in Health Disparities Research, University of Minnesota Medical School, Minneapolis, Minnesota, USA ; Department of Family Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
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Bernardino F, Rentmeister K, Schmidt MJ, Bruehschwein A, Matiasek K, Matiasek LA, Lauda A, Schoon HA, Fischer A. Inferior cerebellar hypoplasia resembling a Dandy-Walker-like malformation in purebred Eurasier dogs with familial non-progressive ataxia: a retrospective and prospective clinical cohort study. PLoS One 2015; 10:e0117670. [PMID: 25668516 PMCID: PMC4323131 DOI: 10.1371/journal.pone.0117670] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 12/10/2014] [Indexed: 12/16/2022] Open
Abstract
Cerebellar malformations can be inherited or caused by insults during cerebellar development. To date, only sporadic cases of cerebellar malformations have been reported in dogs, and the genetic background has remained obscure. Therefore, this study`s objective was to describe the clinical characteristics, imaging features and pedigree data of a familial cerebellar hypoplasia in purebred Eurasier dogs. A uniform cerebellar malformation characterized by consistent absence of the caudal portions of the cerebellar vermis and, to a lesser degree, the caudal portions of the cerebellar hemispheres in association with large retrocerebellar fluid accumulations was recognized in 14 closely related Eurasier dogs. Hydrocephalus was an additional feature in some dogs. All dogs displayed non-progressive ataxia, which had already been noted when the dogs were 5 – 6 weeks old. The severity of the ataxia varied between dogs, from mild truncal sway, subtle dysmetric gait, dysequilibrium and pelvic limb ataxia to severe cerebellar ataxia in puppies and episodic falling or rolling. Follow-up examinations in adult dogs showed improvement of the cerebellar ataxia and a still absent menace response. Epileptic seizures occurred in some dogs. The association of partial vermis agenesis with an enlarged fourth ventricle and an enlarged caudal (posterior) fossa resembled a Dandy-Walker-like malformation in some dogs. Pedigree analyses were consistent with autosomal recessive inheritance.
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Affiliation(s)
- Filipa Bernardino
- Centre for Clinical Veterinary Medicine, Clinic of Small Animal Medicine, Ludwig Maximilian University, Munich, Germany
| | | | - Martin J. Schmidt
- Department of Veterinary Clinical Science, Small Animal Clinic, Justus-Liebig-University, Giessen, Germany
| | - Andreas Bruehschwein
- Centre for Clinical Veterinary Medicine, Clinic of Small Animal Surgery and Reproduction, Ludwig Maximilian University, Munich, Germany
| | - Kaspar Matiasek
- Centre for Clinical Veterinary Medicine, Section of Clinical and Comparative Neuropathology, Ludwig Maximilian University, Munich, Germany
| | - Lara A. Matiasek
- Centre for Clinical Veterinary Medicine, Clinic of Small Animal Medicine, Ludwig Maximilian University, Munich, Germany
| | - Alexander Lauda
- Centre for Clinical Veterinary Medicine, Clinic of Small Animal Medicine, Ludwig Maximilian University, Munich, Germany
| | - Heinz A. Schoon
- Institute of Pathology, Faculty of Veterinary Medicine, University of Leipzig, Leipzig, Germany
| | - Andrea Fischer
- Centre for Clinical Veterinary Medicine, Clinic of Small Animal Medicine, Ludwig Maximilian University, Munich, Germany
- * E-mail:
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Ichizuka K, Mishina M, Hasegawa J, Matsuoka R, Sekizawa A, Pooh RK. Diagnosis of a case of Dandy-Walker malformation aided by measurement of the brainstem-vermis angle at 14 weeks gestation. J Obstet Gynaecol Res 2014; 41:790-3. [DOI: 10.1111/jog.12623] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 09/23/2014] [Indexed: 11/27/2022]
Affiliation(s)
- Kiyotake Ichizuka
- Department of Obstetrics and Gynecology; Showa University Northern Yokohama Hospital; Yokohama Japan
| | - Miyuki Mishina
- Department of Obstetrics and Gynecology; Showa University Northern Yokohama Hospital; Yokohama Japan
| | - Junichi Hasegawa
- Department of Obstetrics and Gynecology; Showa University; Tokyo Japan
| | - Ryu Matsuoka
- Department of Obstetrics and Gynecology; Showa University; Tokyo Japan
| | - Akihiko Sekizawa
- Department of Obstetrics and Gynecology; Showa University; Tokyo Japan
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Kusumoto Y, Shinozuka O. Oral findings and dental treatment in a patient with Dandy-Walker syndrome: a case report. SPECIAL CARE IN DENTISTRY 2014; 34:151-5. [PMID: 24712511 DOI: 10.1111/scd.12044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Dandy-Walker syndrome (DWS) is congenital disease characterized by hypoplasia of the cerebellum, the formation of cysts that communicate with the fourth ventricle of the posterior cranial fossa, and hydrocephalus. In addition to various other complications, cleft lip/palate, facial retrognathia, a high-arched palate, and maldentition occur at an increased frequency in patients with DWS. However, few studies have reported the dental manifestations of DWS. Herein, we report the clinical manifestations, oral findings, and dental management of a DWS patient who was treated under general anesthesia. Poor oral hygiene, gingivitis, and several congenital dental abnormalities (e.g., generalized microdontia, conical tooth, transposition, and congenitally missing teeth) were observed. This report is the first to describe the oral findings and dental treatment of DWS. Our findings emphasize the importance of a multidisciplinary approach in the diagnosis and treatment of DWS.
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Affiliation(s)
- Yasuka Kusumoto
- Section of Dentistry for Persons with Disabilities, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Ferraris A, Bernardini L, Sabolic Avramovska V, Zanni G, Loddo S, Sukarova-Angelovska E, Parisi V, Capalbo A, Tumini S, Travaglini L, Mancini F, Duma F, Barresi S, Novelli A, Mercuri E, Tarani L, Bertini E, Dallapiccola B, Valente EM. Dandy-Walker malformation and Wisconsin syndrome: novel cases add further insight into the genotype-phenotype correlations of 3q23q25 deletions. Orphanet J Rare Dis 2013; 8:75. [PMID: 23679990 PMCID: PMC3667004 DOI: 10.1186/1750-1172-8-75] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Accepted: 05/10/2013] [Indexed: 01/09/2023] Open
Abstract
Background The Dandy-Walker malformation (DWM) is one of the commonest congenital cerebellar defects, and can be associated with multiple congenital anomalies and chromosomal syndromes. The occurrence of overlapping 3q deletions including the ZIC1 and ZIC4 genes in few patients, along with data from mouse models, have implicated both genes in the pathogenesis of DWM. Methods and results Using a SNP-array approach, we recently identified three novel patients carrying heterozygous 3q deletions encompassing ZIC1 and ZIC4. Magnetic resonance imaging showed that only two had a typical DWM, while the third did not present any defect of the DWM spectrum. SNP-array analysis in further eleven children diagnosed with DWM failed to identify deletions of ZIC1-ZIC4. The clinical phenotype of the three 3q deleted patients included multiple congenital anomalies and peculiar facial appearance, related to the localization and extension of each deletion. In particular, phenotypes resulted from the variable combination of three recognizable patterns: DWM (with incomplete penetrance); blepharophimosis, ptosis, and epicanthus inversus syndrome; and Wisconsin syndrome (WS), recently mapped to 3q. Conclusions Our data indicate that the 3q deletion is a rare defect associated with DWM, and suggest that the hemizygosity of ZIC1-ZIC4 genes is neither necessary nor sufficient per se to cause this condition. Furthermore, based on a detailed comparison of clinical features and molecular data from 3q deleted patients, we propose clinical diagnostic criteria and refine the critical region for WS.
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Affiliation(s)
- Alessandro Ferraris
- Mendel Laboratory, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, FG, Italy
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Gardiner K, Chitayat D, Choufani S, Shuman C, Blaser S, Terespolsky D, Farrell S, Reiss R, Wodak S, Pu S, Ray PN, Baskin B, Weksberg R. Brain abnormalities in patients with Beckwith-Wiedemann syndrome. Am J Med Genet A 2012; 158A:1388-94. [DOI: 10.1002/ajmg.a.35358] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Accepted: 02/05/2012] [Indexed: 01/30/2023]
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Guibaud L, Larroque A, Ville D, Sanlaville D, Till M, Gaucherand P, Pracros JP, Portes V. Prenatal diagnosis of ‘isolated’ Dandy-Walker malformation: imaging findings and prenatal counselling. Prenat Diagn 2012; 32:185-93. [DOI: 10.1002/pd.3828] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Anne Larroque
- Département d'Imagerie Pédiatrique et Foetale, Hôpital Femme Mère Enfant; Université Claude Bernard Lyon I; Lyon; France
| | - Dorothée Ville
- Département de Neuropédiatrie, Hôpital Femme Mère Enfant; Université Claude Bernard Lyon I; Lyon; France
| | | | - Marianne Till
- Laboratoire de Cytogénétique Constitutionnelle, Hôpital Femme Mère Enfant; Université Claude Bernard Lyon I; Lyon; France
| | - Pascal Gaucherand
- Centre Pluridisciplinaire de Diagnostic Prénatal, Hôpital Femme Mère Enfant; Université Claude Bernard Lyon I; Lyon; France
| | - Jean-Pierre Pracros
- Département d'Imagerie Pédiatrique et Foetale, Hôpital Femme Mère Enfant; Université Claude Bernard Lyon I; Lyon; France
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Spennato P, Mirone G, Nastro A, Buonocore MC, Ruggiero C, Trischitta V, Aliberti F, Cinalli G. Hydrocephalus in Dandy-Walker malformation. Childs Nerv Syst 2011; 27:1665-81. [PMID: 21928031 DOI: 10.1007/s00381-011-1544-4] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2011] [Accepted: 07/26/2011] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Even if the first description of Dandy-Walker dates back 1887, difficulty in the establishment of correct diagnosis, especially concerning differential diagnosis with other types of posterior fossa CSF collection, still persists. Further confusion is added by the inclusion, in some classification, of different malformations with different prognosis and therapeutic strategy under the same label of "Dandy-Walker". METHODS An extensive literature review concerning embryologic, etiologic, pathogenetic, clinical and neuroradiological aspects has been performed. Therapeutic options, prognosis and intellectual outcome are also reviewed. CONCLUSION The correct interpretation of the modern neuroradiologic techniques, including CSF flow MR imaging, may help in identifying a "real" Dandy-Walker malformation. Among therapeutical strategies, single shunting (ventriculo-peritoneal or cyst-peritoneal shunts) appears effective in the control of both ventricle and cyst size. Endoscopic third ventriculostomy may be considered an acceptable alternative, especially in older children, with the aim to reduce the shunt-related problems. Prognosis and intellectual outcome mostly depend on the presence of associated malformations, the degree of vermian malformation and the adequate control of hydrocephalus.
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Affiliation(s)
- Pietro Spennato
- Department of Pediatric Neurosurgery, Santobono Children's Hospital, Via Mario Fiore n. 6, 80129 Naples, Italy
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Murphy-Ryan M, Babovic-Vuksanovic D, Lindor N. Bifid tongue, corneal clouding, and Dandy-Walker malformation in a male infant with otopalatodigital syndrome type 2. Am J Med Genet A 2011; 155A:855-9. [PMID: 21412975 DOI: 10.1002/ajmg.a.33901] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2010] [Accepted: 12/30/2010] [Indexed: 11/10/2022]
Abstract
We report on a male infant with otopalatodigital syndrome type 2 (OPD2) associated with a novel c.514C>G FLNA mutation and unusual clinical features including bifid tongue and congenital corneal clouding. Bifid tongue and congenital corneal clouding have each only been described once previously in a patient with OPD2, and this is the first description of Dandy-Walker malformation (DWM) in OPD2. The presence of these clinical findings in a mutation-confirmed case of OPD2 supports the notion that corneal clouding, bifid tongue, and DWM are part of the constellation of abnormalities caused by mutations in FLNA.
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Al-Achkar W, Wafa A, Jarjour RA. A new case of de novo translocation (12;17;18)(q21.2;q22;q21.1) and cranio-cerebello-cardiac (3C) syndrome. Am J Med Genet A 2011; 155A:648-51. [PMID: 21337688 DOI: 10.1002/ajmg.a.33742] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2009] [Accepted: 07/18/2010] [Indexed: 11/07/2022]
Affiliation(s)
- Walid Al-Achkar
- Human Genetics Division, Molecular Biology and Biotechnology Department, Atomic Energy Commission of Syria, Damascus, Syria.
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Lamônica DAC, Ferraz PMDP, Ferreira AT, Prado LMD, Abramides DVM, Gejão MG. Síndrome do X Frágil com variante de Dandy-Walker: estudo clínico das manifestações comunicativas orais e escritas. ACTA ACUST UNITED AC 2011; 23:177-82. [DOI: 10.1590/s2179-64912011000200016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2010] [Accepted: 04/06/2011] [Indexed: 11/22/2022]
Abstract
A síndrome do X Frágil é a causa mais frequente de deficiência intelectual hereditária. A variante de Dandy-Walker trata-se de uma constelação específica de achados neurorradiológicos. Este estudo relata achados da comunicação oral e escrita de um menino de 15 anos com diagnóstico clínico e molecular da síndrome do X-Frágil e achados de neuroimagem do encéfalo compatíveis com variante de Dandy-Walker. A avaliação fonoaudiológica foi realizada por meio da Observação do Comportamento Comunicativo, aplicação do ABFW - Teste de Linguagem Infantil - Fonologia, Perfil de Habilidades Fonológicas, Teste de Desempenho Escolar, Teste Illinois de Habilidades Psicolinguísticas, avaliação do sistema estomatognático e avaliação audiológica. Observou-se: alteração de linguagem oral quanto às habilidades fonológicas, semânticas, pragmáticas e morfossintáticas; déficits nas habilidades psicolinguísticas (recepção auditiva, expressão verbal, combinação de sons, memória sequencial auditiva e visual, closura auditiva, associação auditiva e visual); e alterações morfológicas e funcionais do sistema estomatognático. Na leitura verificou-se dificuldades na decodificação dos símbolos gráficos e na escrita havia omissões, aglutinações e representações múltiplas com o uso predominante de vogais e dificuldades na organização viso-espacial. Em matemática, apesar do reconhecimento numérico, não realizou operações aritméticas. Não foram observadas alterações na avaliação audiológica periférica. A constelação de sintomas comportamentais, cognitivos, linguísticos e perceptivos, previstos na síndrome do X-Frágil, somada às alterações estruturais do sistema nervoso central, pertencentes à variante de Dandy-Walker, trouxeram interferências marcantes no desenvolvimento das habilidades comunicativas, no aprendizado da leitura e escrita e na integração social do indivíduo.
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Basel-Vanagaite L, Raas-Rotchild A, Kornreich L, Har-Zahav A, Yeshaya J, Latarowski V, Lerer I, Dobyns WB, Shohat M. Familial hydrocephalus with normal cognition and distinctive radiological features. Am J Med Genet A 2010; 152A:2743-8. [DOI: 10.1002/ajmg.a.33688] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Ocular findings in a case of trisomy 18 with variant of Dandy-Walker syndrome. Pediatr Neonatol 2010; 51:292-5. [PMID: 20951360 DOI: 10.1016/s1875-9572(10)60056-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2009] [Revised: 10/13/2009] [Accepted: 11/12/2009] [Indexed: 11/20/2022] Open
Abstract
Trisomy 18 is the second most common chromosomal syndrome and has multiple dysmorphic features. However, ocular findings in trisomy 18 are rarely reported. Retinal folds are the most common ocular finding described to date, although retinal hypopigmentation, dysplasia, and areas of hemorrhage and gliosis are also found in trisomy 18. Dandy-Walker syndrome is a brain malformation that has been reported in association with numerous chromosomal abnormalities, although it has rarely been reported in association with trisomy 18. Here, we present a case of trisomy 18 with ocular pathology and variant of Dandy-Walker syndrome, a combination that has not previously been reported.
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Siggberg L, Ala-Mello S, Jaakkola E, Kuusinen E, Schuit R, Kohlhase J, Böhm D, Ignatius J, Knuutila S. Array CGH in molecular diagnosis of mental retardation - A study of 150 Finnish patients. Am J Med Genet A 2010; 152A:1398-410. [PMID: 20503314 DOI: 10.1002/ajmg.a.33402] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We report on the results of an array comparative genomic hybridization (array CGH) study of 150 karyotypically normal Finnish patients with idiopathic mental retardation and/or dysmorphic features and/or malformations. Using high-resolution microarray analysis, we sought to identify clinically relevant microdeletions and microduplications in these patients. The results were confirmed using other methods and compared with findings reported in recent publications and internet databases. Small aberrations of potential clinical significance were found in 28 (18.6%) of the 150 patients. Eight of the identified aberrations are known to cause syndromes, 4 affected the X chromosome in males, 4 were familial, and 13 have yet to be associated with a phenotype. This study demonstrates the benefits of array CGH in clinical diagnostics of developmental disorders. Further, our findings give evidence of new syndromes.
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Affiliation(s)
- Linda Siggberg
- Department of Pathology, Haartman Institute, University of Helsinki, Helsinki, Finland.
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Salihu HM, Kornosky JL, Alio AP, Druschel CM. Racial Disparities in Mortality Among Infants With Dandy-Walker Syndrome. J Natl Med Assoc 2009; 101:456-61. [DOI: 10.1016/s0027-9684(15)30932-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
This article presents a case review of a newborn diagnosed with a complex chromosomal rearrangement, as demonstrated through a painted chromosomal analysis. This infant presented with multiple dysmorphology including cutis aplasia, multiple ocular malformations, bilateral cleft lip and palate, and postnatal hydrocephaly. A chromosomal analysis revealed multiple-ways, balanced translocation involving chromosomes 3, 4, 6, 8, and 9. This case study provides a unique opportunity to, in retrospect, trace each malformation exploring the pathophysiology, etiology, and correlating origin with chromosomal variation. Careful review of this case, enhanced by the visually augmented representation of each translocation, will increase understanding of chromosomal anomalies and their implications in embryological development and clinical presentation.
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