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DOI: 10.1055/s-0038-1672947
Cerebral abnormalities related to myelomeningocele: MR imaging evaluation
Publication History
Publication Date:
06 September 2018 (online)
Objective: Myelomeningocele (MMC) is often related to intracranial abnormalities, being hydrocephalus and Chiari malformation (CM) type 2 the more prevalent. However, several other brain abnormalities have been identified, but poorly explored. Evaluate cerebral abnormalities associated with MMC.
Material and Methods: Between January 2014 to March 2017, 59 patients with MMC were treated in our hospital, by postnatal or in utero repair. Of these, 37 patients with brain magnetic resonance imaging (MRI) were enrolled in the study. All images were evaluated by two independents experienced neuroradiologist, to document morphological cerebral abnormalities.
Results: Brain MRI revealed: hydrocephalus in 93% of the patients, of whom 54% required shunting until the date of data analysis. Total agenesis of the corpus callosum was observed in 2.7% of the patients, partial agenesis was seen in 27% of the patients and 69% of the patients had dysplasia of the corpus callosum. Absence of the septum pellucidum was observed in 38% and colpocephaly were noted in 96% of the patients. Malformations of cortical development included pachygyria (5%), stenogyria (35%), polymicrogyria (8%) and abnormal white matter maturation (8%). Others supratentorial findings were: falx hypoplasia with gyral interdigitations (81%), interthalamic adhesion 84%, gray matter heterotopic nodules 16.2% and hypothalamic adhesion 19%. Small posterior fossa was observed in 31% of the patients, Chiari malformation in 94% of the patients, cerebellar and brain stem hypoplasia in 8% and 82% of the patients, respectively. Aqueductal stenosis was described in 54%, and cervical syringe in 36%.
Conclusion: This study focused on the structural findings of brain MRI of children with myelomeningocele. More studies to address the correlation of these abnormalities with long-term functional outcomes are needed.