Perfusion Abnormalities in Hemimegalencephaly

P. Wintermark; E. Roulet-Perez; M. Maeder-Ingvar; A. C. Moessinger; F. Gudinchet; R. Meuli

doi:10.1055/s-0029-1237721

Neuropediatrics, Table of Contents

Neuropediatrics 2009; 40(2): 92-96
DOI: 10.1055/s-0029-1237721

Short Communication

Perfusion Abnormalities in Hemimegalencephaly

P. Wintermark¹ , E. Roulet-Perez² , M. Maeder-Ingvar³ , A. C. Moessinger¹ , F. Gudinchet⁴ , R. Meuli⁴

¹Division of Neonatology, Department of Pediatrics, University Hospital (CHUV) and Lausanne Medical School, Lausanne, Switzerland
²Unit of Pediatric Neurology and Rehabilitation, Department of Pediatrics, University Hospital (CHUV) and Lausanne Medical School, Lausanne, Switzerland
³Department of Neurology, University Hospital (CHUV) and Lausanne Medical School, Lausanne, Switzerland
⁴Department of Radiology, University Hospital (CHUV) and Lausanne Medical School, Lausanne, Switzerland

Abstract

Introduction: Cerebrovascular changes are rarely discussed in patients with hemimegalencephaly. These alterations have previously been associated with epileptical activity.

Case: We report the case of a 36-week gestation neonate presenting with total right hemimegalencephaly, as demonstrated by a magnetic resonance imaging (MRI) performed in the first days of life. Perfusion-weighted imaging displayed a clear hypervascularization of the right hemisphere. Diffusion-tensor imaging showed an arrangement of white matter fibers concentrically around the ventricle on the right hemisphere. AngioMRI showed an obvious asymmetry in the size of the middle cerebral arteries, with the right middle cerebral artery being prominent. The baby was free of clinical seizures during his first week of life. An electroencephalogram at that time displayed an asymmetric background activity, but no electrical seizures.

Conclusion: Perfusion anomalies in hemimegalencephaly may not necessarily be related to epileptical activity, but may be related to vessel alterations.

Key words

hemimegalencephaly - magnetic resonance imaging - perfusion-weighted imaging - diffusion-tensor imaging

Full Text

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Correspondence

Pia WintermarkMD

c/o Adrien Moessinger

Division of Neonatology

Department of Pediatrics

University Hospital and Lausanne Medical School

CHUV

1011 Lausanne

Switzerland

Phone: +41/21/314 36 68

Fax: +41/21/314 34 77

Email: Pia.Wintermark@bluemail.ch