Journal of Pediatric Neuroradiology - Volume 3, issue 2

Authors: Diallo, Ousséini | Jissendi-Tchofo, Patrice | Kabré, Abel | Napon, Madina Aïcha | Ouattara, Boubacar | Bamouni, Abel | Lougué-Sorgho, Claudine | Cissé, Rabiou

Article Type: Review Article

Abstract: The purpose of this study was to describe the use of cranial computerized tomography (CT) imaging in children with nasofrontal cephaloceles. We report the results in six children, four females and two males, aged day 1 to ten years. We include clinical notes, photographs and CT images collected over 2 years in Burkina Faso. We found various aspects of facial dysmorphisms and cranial CT associated with nasofrontal cephaloceles as observed in five children; the sixth showed a complex form of mixed nasofrontal and nasoorbital defects. Other common malformations were interhemispheric cysts and agenesis of the corpus callosum. The joint …description of facial dysmorphism and cranial CT features in nasofrontal cephaloceles emphasizes the importance of making the correct diagnosis in developing countries. This allows planning for reconstructive surgery, which can have a favorable impact on the family’s and society’s attitude towards these children. Show more

Keywords: Cephaloceles, nasal fistula, corpus callosum agenesis, cranial computed tomography

DOI: 10.3233/PNR-14089

Citation: Journal of Pediatric Neuroradiology, vol. 3, no. 2, pp. 55-61, 2014

Authors: Jain, Krishan K. | Paliwal, Vimal K. | Yadav, Abhinav | Roy, Bhaswati | Goel, Puneet | Chaturvedi, Saurabh | Chaurasia, Ankita | Garg, Ravindra K. | Rathore, Ram K.S. | Gupta, Rakesh K.

Article Type: Other

Abstract: It is known that patients with chronic hypoxia have regional changes in their cerebral blood flow (CBF). The purpose of this study was to observe the CBF and diffusion tensor imaging (DTI) metrics changes in children with cerebral palsy (CP) at baseline and after 6 months of treatment. Thirty-eight children with cerebral diplegia (mean age = 6.4 yr) and twenty-one age/sex matched controls (mean age = 7.5 yr) were evaluated by the Gross Motor Function Classification System (GMFCS) scoring of motor disability and modified Ashworth scoring of spasticity. All subjects underwent pseudo-continuous arterial spin labeling (PCASL) and DTI, in addition …to conventional magnetic resonance imaging (MRI). Significant increase in CBF values was observed in several grey and white matter regions (including areas of abnormal T2 hyperintensity in the periventricular white matter) in CP children as compared to controls based upon voxel-wise analysis. Low fractional anisotropy (FA) and high apparent diffusion coefficient (ADC) values were observed in these areas of high CBF, using a region of interest (ROI) based analysis. On follow-up study, CBF values were found to be significantly higher in two grey matter areas and lower in three white matter regions in comparison to baseline; however no significant changes in DTI indices were observed in these regions. CBF values are high in CP children as compared to controls and show alteration following therapy even when the DTI metrics remain unchanged. Arterial spin labeling (ASL) may be added to the advanced imaging protocol for studying brain plasticity in such children in future. Show more

Keywords: Cerebral palsy, cerebral blood flow, voxel wise analysis, diffusion tensor imaging, arterial spin labeling, brain

DOI: 10.3233/PNR-14088

Citation: Journal of Pediatric Neuroradiology, vol. 3, no. 2, pp. 63-73, 2014

Authors: Riviello, Peter J. | Tyagi, Vineet | Milla, Sarah Sarvis

Article Type: Other

Abstract: Septo-optic dysplasia is an uncommon diagnosis comprised in part of a unique composition of congenital malformations of the central nervous system. It is defined by three principle findings: optic nerve hypoplasia, absence of the septum pellucidum, and clinical pituitary dysfunction. The syndrome may be associated with various cerebral defects including ectopic posterior pituitary, dysgenesis of the corpus callosum, and malformations of cortical development such as schizencephaly. Septo-optic dysplasia has been compared to holoprosencephaly due to the presence of anterior midline defects and is thought to be a less severe form of lobar holoprosencephaly. Certain neuroradiological features may predict clinical outcomes: …patients with malformations of cortical development or ectopic posterior pituitary are at higher risk for neurodevelopmental or endocrine dysfunction, respectively. Here we report a case of unilateral optic nerve hypoplasia with asymmetric appearance of the septum pellucidum thought to be due to ipsilateral absence of the septal leaflet in an otherwise healthy infant with exotropia. This is the first case of suspected unilateral septo-optic dysplasia described in the literature. Show more

Keywords: Septo-optic dysplasia, absent septum, unilateral optic nerve hypoplasia

DOI: 10.3233/PNR-14090

Citation: Journal of Pediatric Neuroradiology, vol. 3, no. 2, pp. 75-79, 2014

Authors: Bindu, Parayil S. | Mahadevan, Anita | Taly, Arun B. | Chickabasaviah, Yasha T. | Bharath, Rose D. | Nagappa, Madhu | Sinha, Sanjib

Article Type: Other

Abstract: We report the radiologic findings in two children with Griscelli syndrome who presented mainly with neurologic findings. Both children were born to consanguineous parents, had normal birth and developmental histories; both had silvery gray hair from the time of birth. The first child presented with symptoms of increased intracranial pressure and cerebellar ataxia; the second child with cerebellar ataxia alone. Microscopic examination of the hair in both the children demonstrated the characteristic melanin clumps suggestive of Griscelli syndrome. Magnetic resonance imaging of the brain in the first child demonstrated multifocal white matter hyperintensities in the cerebrum and diffuse white matter …hyperintensities in the cerebellum, with intense contrast enhancement. In the second child, signal changes were confined to the cerebellum and spinal cord. The first child succumbed to rapidly progressive increased intra-cranial pressure; partial autopsy revealed necrotizing lesions involving the cerebellar hemispheres bilaterally which corresponded to the neuroimaging abnormalities. Histology revealed diffuse histiocytic infiltration of the parenchyma. Griscelli syndrome type 2 should be a diagnostic consideration in a child with silvery hair, neurological deterioration and enhancing multifocal white matter signal intensity changes Show more

Keywords: Griscelli syndrome, silvery hair, cerebellar leukoencephalopathy, melanin clumps

DOI: 10.3233/PNR-14091

Citation: Journal of Pediatric Neuroradiology, vol. 3, no. 2, pp. 81-86, 2014

Authors: Hegde, Vinay S. | Saini, Jitender | Ram, Ananta | Sabharwal, Paramveer S. | Bindu, Parayil S.

Article Type: Other

Abstract: Lissencephaly, with posterior-anterior gradient, are congenital brain malformations characterized by the presence of a few broad, flat gyri with thickened cortex. It results from the arrest of neuronal migration in early gestation. Magnetic resonance imaging (MRI) findings are characteristic and show thickened dysplastic cortex with a paucity of gyri and sulci. We report a case of lissencephaly with posterior-anterior gradient with unique imaging findings on susceptibility weighted imaging. Susceptibility weighted imaging revealed prominent venous channels traversing the thickened cortex. These channels possibly represent primitive vessels, similar to those seen in early cortical development, and can probably be seen due to …the enormously thickened cortex in case of lissencephaly. Show more

Keywords: Lissencephaly, susceptibility weighted imaging, persistent fetal vasculature

DOI: 10.3233/PNR-14092

Citation: Journal of Pediatric Neuroradiology, vol. 3, no. 2, pp. 87-90, 2014

Authors: Anık, Yonca | Yücesoy, Gülseren | Anık-İlhan, Gökçe

Article Type: Other

Abstract: Fetal magnetic resonance imaging (MRI) findings of Dandy-Walker malformation are presented in twins at 22 weeks of gestation. The mother was 22 years-old. Prenatal ultrasonography at 18 weeks revealed mega cisterna magna in one fetus and a borderline cisterna magna in the other fetus of monochorionic diamniotic twins. Fetal MRI findings were consistent with Dandy-Walker Syndrome in one and Dandy-Walker variant in the other fetus. Dandy-Walker malformation affecting both fetuses of the twins is extremely rare. Although ultrasonography is the primary modality for the diagnosis, fetal MRI is an important tool to confirm the diagnosis, to describe the anatomic features …in detail and to identify associated anomalies. Show more

Keywords: Fetal magnetic resonance imaging, Dandy-Walker malformation, monochorionic diamniotic twins

DOI: 10.3233/PNR-14093

Citation: Journal of Pediatric Neuroradiology, vol. 3, no. 2, pp. 91-94, 2014

Authors: Pekcevik, Yeliz | ş&!#x015F;ahin, Hilal

Article Type: Other

Abstract: We present brain magnetic resonance imaging, diffusion weighted imaging and proton magnetic resonance spectroscopy findings in a 13-year-old patient who presented with vision loss and behavioral changes after trauma. Elevated measles antibody titers in the plasma and cerebrospinal fluid confirmed the diagnosis of subacute sclerosing panencephalitis.

Keywords: Subacute sclerosing panencephalitis, magnetic resonance spectroscopy, diffusion magnetic resonance imaging, visual loss

DOI: 10.3233/PNR-14094

Citation: Journal of Pediatric Neuroradiology, vol. 3, no. 2, pp. 95-98, 2014

Authors: Maria Alexandre, Andrea | Napoli, Giuseppe | Sanna, Antioco | Leoni, Chiara | Ruggiero, Maria

Article Type: Other

Abstract: Posterior reversible encephalopathy syndrome, also known as reversible posterior leukoencephalopathy syndrome or reversible posterior cerebral edema syndrome, is a recently described disorder of the cerebrovascular autoregulation system with multiple etiologies, most of which cause acute hypertension. Its clinical symptoms include headache, decreased alertness, mental abnormalities such as confusion, diminished spontaneity of speech, and changed behavior, stupor, seizures, vomiting, and abnormalities of visual perception such as cortical blindness. Radiologic appearance consists in cortical/subcortical posterior cerebral artery territory lesions. We describe two cases of this disease in pediatric patients caused by different clinical conditions but supported by the same pathophysiology. Early recognition …of posterior reversible encephalopathy syndrome as a complication during different diseases and therapies in childhood may facilitate precise diagnosis and appropriate treatment. Show more

Keywords: Posterior reversible encephalopathy syndrome (PRES), PRES associated diseases, magnetic resonance imaging, child

DOI: 10.3233/PNR-14095

Citation: Journal of Pediatric Neuroradiology, vol. 3, no. 2, pp. 99-103, 2014