Journal of Pediatric Neuroradiology - Volume 1, issue 1
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Journal of Pediatric Neuroradiology is an English multidisciplinary peer-reviewed international journal providing a forum for the publication of papers on all topics related to child neuroradiology including diagnostic, functional and therapeutic imaging of the brain, head, neck, spine; congenital central nervous system malformations; pediatric ophthalmologic and otorhinolaryngologic imaging.
Journal of Pediatric Neuroradiology provides an in-depth update on new subjects, and current comprehensive coverage of the latest techniques in neuroradiological diagnosis and treatment in childhood.
Journal of Pediatric Neuroradiology encourages submissions from all authors throughout the world.
The following articles will be considered for publication: editorials, original and review articles, short report, rapid communications, case reports, letters to the editor, and book reviews. The aim of the journal is to share and disseminate knowledge between all disciplines that work in the field of child neuroradiology.
Abstract: The diagnosis of pediatric orbital and periorbital conditions is addressed by a combination of a good clinical history, examination, fundoscopy and imaging. The main imaging modalities available are ultrasound, computed tomography and magnetic resonance imaging. This pictorial review focuses on the relative advantages of imaging methods in common pediatric orbital and periorbital pathology. Salient features of each condition will be discussed, providing key diagnostic signs to aid evaluation of children presenting with orbital symptoms and signs.
Keywords: Pediatrics, orbit and periorbital imaging, MRI, CT
Abstract: Mesial temporal sclerosis is one of the most common pathologies seen in patients with temporal lobe epilepsy. Complex partial seizures arise from the mesial (deepest) part of the temporal region. This region includes the amygdala and the hippocampus. The etiology of mesial temporal sclerosis is still uncertain and controversial. The most popular mechanism implicated in this pathology involves glutamate, an amino acid whose release results in excessive excitability. This model is documented both in animals and in humans. The other mechanism describes neuronal death from seizure induced gene expression and seizure induced energy metabolism deficits. There are many theories linked…to the development of this lesion. It is seen as a rare pathological finding in children less than 10 years of age, but it is not uncommon in adolescence. Clinical studies are suggestive of the occurrence of lesions in children with prolonged febrile seizures. The other etiologies include perinatal ischemic insult, hypoglycemia, intrauterine hypoxia, and status epilepticus resulting in hypoxia and edema in the hippocampus. Magnetic resonance imaging is the modality of choice for the detection of the lesion, which demonstrates scarring in the mesial temporal region. The coronal high-resolution fluid-attenuated inversion recovery is known to be one of the best sequences, since sensitivity is high to detect the hyperintensity and atrophy of the hippocampus. The use of magnetic resonance imaging is crucial for the pre-surgical work up for epilepsy. Specific surgical procedures including anterior temporal lobectomy tailored towards resection of the mesial temporal lesion have a much higher rate of success in intractable epilepsy patients. Seizure freedom is seen in 70–95% of patients undergoing resective surgery as compared with 25% of medically treated cases.
Abstract: Recent findings suggest that in addition to severe hypoglycemia, chronic hyperglycemia may also hamper the cognitive development of patients with type 1 diabetes. Executive and memory dysfunctions mediated by frontoparietal and temporal brain structures are frequently reported to be associated with type 1 diabetes. However, most studies investigating pediatric patients with diabetes focus on either brain function or brain structure. The current study combines neuropsychological and structural brain imaging methods (i.e., voxel-based-morphometry) to study the neurofunctional integrity of frontoparietal brain areas. We investigated 30 children with type 1 diabetes and 19 healthy controls. Children with diabetes were divided into…two groups representing better (HbA1c ≤ 7.9%) and worse (HbA1c ≥ 8.0%) glycemic control. Our findings were threefold: First, results revealed significant group differences with respect to neuropsychological performance (i.e. response accuracies on a marker task tapping frontoparietal brain functions). Second, structural imaging disclosed significant group differences between patients and controls regarding gray matter volume in frontal (anterior cingulate) and occipital (cuneus, bordering precuneus) brain regions and regarding white matter in middle temporal and occipital gyri as well as in the ventromedial temporal lobe (uncus). Third, disease duration, age at diagnosis and white matter volume in a hippocampal region-of-interest (but not HbA1c levels, intelligence, total gray/white matter or other white/gray matter regions-of-interest) explained 56% of neuropsychological performance variance. Taken together, our findings are among the first to provide evidence of a direct link between brain function and brain structure in pediatric patients with type 1 diabetes.
Keywords: Type 1 diabetes, neuropsychological performance, HbA1c, voxel-based-morphometry, gray matter, white matter, metabolic control, neurocognition, pediatrics
Abstract: The purpose of this study was to determine the growth of lateral ventriclar size of fetuses between 15 and 25 weeks of gestation. A prospective study of normal singleton pregnancies was evaluated consecutively. Measurement of the lateral ventricle was performed by transabdominal sonography as a part of routine obstetric examination in 338 fetuses. The mean size of the lateral ventricular atrial diameter for the 338 fetuses was 6.65 ± 0.95 mm. A weak correlation was found between gestational age and lateral ventricle width (R2 = 0.03, P < 0.001). In addition, there was a weak correlation between biparietal…diameter and lateral ventricle width (R2 = 0.062, P < 0.001). The mean size was correlated with the others in the literature. The lateral ventricle size was stable across the second trimester. Since there was a weak correlation, and overlapping values throughout the gestation weeks, it seems clinically impractical to use a nomogram of the lateral ventricle size. However, a value of upper limit (10 mm) may be a clue for lateral ventricular dilatation, and close follow-up may be helpful.
Abstract: To evaluate diffusion imaging characteristics of parenchymal changes in patients with tuberous sclerosis complex (TSC) compared with those in control subjects. We reviewed magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) findings in six patients diagnosed with TSC. MRI examinations were performed in a 1.5 Tesla MRI unit using a transmit/receive coil with T1-weighted and T2-weighted spin-echo and fluid-attenuated inversion recovery sequences. DWI MRI was obtained using an echo-planar imaging sequence. Apparent diffusion coefficient (ADC) values were measured. In addition, five normal children were studied for comparison. ADC was higher in cortical tubers than in the corresponding cortical location of…controls (p < 0.05). ADC values were higher in white-matter lesions and perilesional white matter than in the contralateral normal-appearing white matter of both patients and controls (p < 0.05). There were no differences for ADC values between the normal-appearing white matter of patients with TSC and control subjects. It appears that DWI MRI can be useful in the evaluation of parenchymal changes associated with TSC.
Abstract: A healthy 6-week-old white male presented with an intermittently enlarging reddish-blue plaque on the midline forehead and frontal scalp. Neuroimaging revealed an abnormal vascular communication between the extracranial and intracranial venous systems. This rare condition is termed sinus pericranii. The authors provide a review of sinus pericranii and describe its imaging findings, embryologic derivation, differential diagnosis, and clinical management.
Abstract: There are very few reports describing paraplegia of spinal origin after cardiac arrest in adults and none in pediatrics. We report a case of spinal cord injury with spinal subdural hematoma after chest compressions. A 4-month-old male infant with a hypoplastic left ventricle underwent cardiac transplantation at the age of three months. Two weeks after transplant, an episode of asystole and ventricular fibrillation of unknown origin occurred. His resuscitation included a 10-minute period of chest compressions. After sedation was discontinued, the patient was found to be paraplegic. Spinal magnetic resonance imaging showed a subdural hematoma and a hemorrhagic medullary contusion…extending from T4 to T10 with a subarachnoid hemorrhage extending from T10 to S2. Adequate compression to ensure support of circulation is life saving but pediatricians must be aware of the potential risk of spinal cord injury after chest compressions.
Abstract: We serially investigated the clinical course, T1- or T2-weighted magnetic resonance imaging (MRI), and diffusion-weighted imaging (DWI) features in a patient with Leigh syndrome. In the early phase, DWI sensitivity for detection of the lesions was similar to that of T1- or T2-weighted MRI. In the chronic phase, however, signals showed a discrepancy between DWI and T1- or T2-weighted images. The T2 hyperintensity persisted and showed no changes during his clinical regression. In contrast, the signals on DWI returned to normal (isointensity). In the medulla oblongata, the apparent diffusion coefficient (ADC) values in the affected areas (0.63 and 0.59 x…10−3 mm2 /s) were lower than those of the unaffected area (0.78 ± 0.04 and 0.76 ± 0.05 x 10−3 mm2 /s) at 14 and 16 months. In contrast, at 25 months of age, the ADC value in the affected area (0.87 x 10−3 mm2 /s) was slightly higher than those of the unaffected area (0.75 ± 0.03 x 10−3 mm2 /s). These findings may reflect the pseudonormalization, which is considered to reflect pathologic changes of progressive gliosis and decreased neuronal density. Serial DWI studies may be useful not only for initial diagnosis, but also for reconsideration of pathophysiologic changes of lesions in Leigh syndrome.