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Kocaaga A, Bildirici Y, Yimenicioglu S, Karademir-Arslan NC, Vural C, Yildirim E. Case report: Pai syndrome with multiple ventricular septal defect and without cleft palate. Clin Neurol Neurosurg 2024; 236:108045. [PMID: 38091702 DOI: 10.1016/j.clineuro.2023.108045] [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: 08/21/2023] [Revised: 11/03/2023] [Accepted: 11/03/2023] [Indexed: 02/04/2024]
Abstract
Pai syndrome is described as the association of a midline cleft lip, midline facial polyps, and lipoma of the central nervous system. However, only a few patients present the full triad, and most exhibit a wide spectrum of phenotypic variability. Its entire clinical spectrum is still poorly delineated and the etiology remains unknown. In this report, a newborn was presented with congenital nasal septal lipoma, lipoma of the corpus callosum, multiple ventricular septal defect, and additional minor facial dysmorphism. This entity, multiple ventricular septal defect, which has never been reported in PS. Cytogenetic analysis showed normal male 46, XY karyotype. Chromosomal microarray analysis (750 K array) was also unremarkable. This case draws attention with the presence of multiple ventricular septal defect in Pai syndrome and is important in terms of providing phenotypic diversity. To our knowledge, this is also the first genetically evaluated case of Pai syndrome from Turkey.
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Affiliation(s)
- A Kocaaga
- Medical Genetics Department, Eskişehir City Hospital, Eskişehir Şehir Hastanesi, 71 Evler Mahallesi, Çavdarlar Sokak, TR 26080 Odunpazarı, Eskişehir, Turkiye.
| | - Y Bildirici
- Department of Pediatrics, Eskişehir City Hospital, Eskişehir Şehir Hastanesi, 71 Evler Mahallesi, Çavdarlar Sokak, TR 26080 Odunpazarı, Eskişehir, Turkiye
| | - S Yimenicioglu
- Department of Pediatric Neurology, Eskişehir City Hospital, Eskişehir Şehir Hastanesi, 71 Evler Mahallesi, Çavdarlar Sokak, TR 26080 Odunpazarı Eskişehir, Turkiye
| | - N C Karademir-Arslan
- Department of Pediatric Neurology, Eskişehir City Hospital, Eskişehir Şehir Hastanesi, 71 Evler Mahallesi, Çavdarlar Sokak, TR 26080 Odunpazarı Eskişehir, Turkiye
| | - C Vural
- Department of Pediatric Cardiology, Eskişehir City Hospital, Eskişehir Şehir Hastanesi, 71 Evler Mahallesi, Çavdarlar Sokak, TR 26080 Odunpazarı, Eskişehir, Turkiye
| | - E Yildirim
- Department Neonatal Intensive Care, Eskişehir City Hospital, Eskişehir Şehir Hastanesi, 71 Evler Mahallesi, Çavdarlar Sokak, TR 26080 Odunpazarı, Eskişehir, Turkiye
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2
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Diogo MC, Glatter S, Prayer D, Gruber GM, Bettelheim D, Weber M, Dovjak G, Seidl R, Kasprian G. Improved neurodevelopmental prognostication in isolated corpus callosal agenesis: fetal magnetic resonance imaging-based scoring system. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2021; 58:34-41. [PMID: 32484578 PMCID: PMC8362015 DOI: 10.1002/uog.22102] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 05/07/2020] [Accepted: 05/18/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES Corpus callosal agenesis (CCA) is one of the most common brain malformations and is generally associated with a good outcome when isolated. However, up to 25% of patients are at risk of neurodevelopmental delay, which currently available clinical and imaging parameters are inadequate to predict. The objectives of this study were to apply and validate a fetal magnetic resonance imaging (MRI) anatomical scoring system in a cohort of fetuses with isolated CCA and to evaluate the correlation with postnatal neurodevelopmental outcome. METHODS This was a retrospective cohort study of cases of prenatally diagnosed isolated CCA (as determined on ultrasound and MRI), with normal karyotype and with known postnatal neurodevelopmental outcome assessed by standardized testing. A fetal brain MRI anatomical scoring system based on seven categories (gyration, opercularization, temporal lobe symmetry, lamination, hippocampal position, basal ganglia and ventricular size) was developed and applied to the cohort; a total score of 0-11 points could be given, with a score of 0 representing normal anatomy. Images were scored independently by two neuroradiologists blinded to the outcome. For the purpose of assessing the correlation between fetal MRI score and neurodevelopmental outcome, neurodevelopmental test results were scored as follows: 0, 'below average' (poor outcome); 1, 'average'; and 2, 'above average' (good outcome). Spearman's rank coefficient was used to assess correlation, and inter-rater agreement in the assessment of fetal MRI score was calculated. RESULTS Twenty-one children (nine females (42.9%)) fulfilled the inclusion criteria. Thirty-seven fetal MRI examinations were evaluated. Mean gestational age was 28.3 ± 4.7 weeks (range, 20-38 weeks). All fetuses were delivered after 35 weeks' gestation with no perinatal complications. Fetal MRI scores ranged from 0 to 6 points, with a median of 3 points. Inter-rater agreement in fetal MRI score assessment was excellent (intraclass correlation coefficient, 0.959 (95% CI, 0.921-0.979)). Neurodevelopmental evaluation was performed on average at 2.6 ± 1.46 years (range, 0.5-5.8 years). There was a significant negative correlation between fetal MRI score and neurodevelopmental outcome score in the three areas tested: cognitive (ρ = -0.559, P < 0.0001); motor (ρ = -0.414, P = 0.012) and language (ρ = -0.565, P < 0.0001) skills. Using fetal MRI score cut-offs of ≤ 3 (good outcome) and ≥ 4 points (high risk for poor outcome), the correct prognosis could be determined in 20/21 (95.2% (95% CI, 77.3-99.2%)) cases. CONCLUSION By assessing structural features of the fetal brain on MRI, it may be possible to better stratify prenatally the risk of poor neurodevelopmental outcome in CCA patients. © 2020 Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- M. C. Diogo
- Department of Radiology, Division of Neuro‐ and Musculoskeletal RadiologyMedical University of ViennaViennaAustria
- Neuroradiology DepartmentHospital Garcia de OrtaAlmadaPortugal
| | - S. Glatter
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric NeurologyMedical University of ViennaViennaAustria
| | - D. Prayer
- Department of Radiology, Division of Neuro‐ and Musculoskeletal RadiologyMedical University of ViennaViennaAustria
| | - G. M. Gruber
- Department of Radiology, Division of Neuro‐ and Musculoskeletal RadiologyMedical University of ViennaViennaAustria
- Department of Anatomy and BiomechanicsKarl Landsteiner University of Health SciencesKremsAustria
| | - D. Bettelheim
- Department of Gynecology and ObstetricsMedical University of ViennaViennaAustria
| | - M. Weber
- Department of Radiology, Division of Neuro‐ and Musculoskeletal RadiologyMedical University of ViennaViennaAustria
| | - G. Dovjak
- Department of Radiology, Division of Neuro‐ and Musculoskeletal RadiologyMedical University of ViennaViennaAustria
| | - R. Seidl
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric NeurologyMedical University of ViennaViennaAustria
| | - G. Kasprian
- Department of Radiology, Division of Neuro‐ and Musculoskeletal RadiologyMedical University of ViennaViennaAustria
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Cornejo P, Feygin T, Vaughn J, Pfeifer CM, Korostyshevska A, Patel M, Bardo DME, Miller J, Goncalves LF. Imaging of fetal brain tumors. Pediatr Radiol 2020; 50:1959-1973. [PMID: 33252762 DOI: 10.1007/s00247-020-04777-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 05/13/2020] [Accepted: 07/08/2020] [Indexed: 12/12/2022]
Abstract
Congenital brain tumors, defined as those diagnosed prenatally or within the first 2 months of age, represent less than 2% of pediatric brain tumors. Their location, prevalence and pathophysiology differ from those of tumors that develop later in life. Imaging plays a crucial role in diagnosis, tumor characterization and treatment planning. The most common lesions diagnosed in utero are teratomas, followed by gliomas, choroid plexus papillomas and craniopharyngiomas. In this review, we summarize the pathogenesis, diagnosis, management and prognosis of the most frequent fetal brain tumors.
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Affiliation(s)
- Patricia Cornejo
- Department of Radiology, Phoenix Children's Hospital, 1919 E. Thomas Road, Phoenix, AZ, 85016, USA. .,Department of Neuroradiology, Barrows Neurological Institute, Phoenix, AZ, USA. .,Department of Radiology, University of Arizona College of Medicine, Phoenix, AZ, USA. .,Department of Radiology, Mayo Clinic Arizona, Phoenix, AZ, USA. .,Department of Radiology, Creighton University School of Medicine, Phoenix, AZ, USA.
| | - Tamara Feygin
- Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Jennifer Vaughn
- Department of Radiology, Phoenix Children's Hospital, 1919 E. Thomas Road, Phoenix, AZ, 85016, USA.,Department of Neuroradiology, Barrows Neurological Institute, Phoenix, AZ, USA.,Department of Radiology, University of Arizona College of Medicine, Phoenix, AZ, USA.,Department of Radiology, Creighton University School of Medicine, Phoenix, AZ, USA
| | - Cory M Pfeifer
- Department of Radiology, UT Southwestern, Dallas, TX, USA
| | - Alexandra Korostyshevska
- International Tomography Center of the Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russian Federation
| | - Mittun Patel
- Department of Radiology, Phoenix Children's Hospital, 1919 E. Thomas Road, Phoenix, AZ, 85016, USA.,Department of Radiology, University of Arizona College of Medicine, Phoenix, AZ, USA.,Department of Radiology, Creighton University School of Medicine, Phoenix, AZ, USA
| | - Dianna M E Bardo
- Department of Radiology, Phoenix Children's Hospital, 1919 E. Thomas Road, Phoenix, AZ, 85016, USA.,Department of Neuroradiology, Barrows Neurological Institute, Phoenix, AZ, USA.,Department of Radiology, University of Arizona College of Medicine, Phoenix, AZ, USA.,Department of Radiology, Mayo Clinic Arizona, Phoenix, AZ, USA.,Department of Radiology, Creighton University School of Medicine, Phoenix, AZ, USA
| | - Jeffrey Miller
- Department of Radiology, Phoenix Children's Hospital, 1919 E. Thomas Road, Phoenix, AZ, 85016, USA.,Department of Neuroradiology, Barrows Neurological Institute, Phoenix, AZ, USA.,Department of Radiology, University of Arizona College of Medicine, Phoenix, AZ, USA.,Department of Radiology, Mayo Clinic Arizona, Phoenix, AZ, USA.,Department of Radiology, Creighton University School of Medicine, Phoenix, AZ, USA
| | - Luis F Goncalves
- Department of Radiology, Phoenix Children's Hospital, 1919 E. Thomas Road, Phoenix, AZ, 85016, USA.,Department of Radiology, University of Arizona College of Medicine, Phoenix, AZ, USA.,Department of Radiology, Creighton University School of Medicine, Phoenix, AZ, USA
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Rochtus A, Vinckx J, de Zegher F. Hypothalamic lipoma and growth hormone deficiency. INTERNATIONAL JOURNAL OF PEDIATRIC ENDOCRINOLOGY 2020; 2020:4. [PMID: 32042280 PMCID: PMC7001293 DOI: 10.1186/s13633-020-0074-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 01/27/2020] [Indexed: 11/10/2022]
Abstract
Background Intracranial lipomas are rare, congenital lesions, most often located at the midline. Most hypothalamic lipomas are asymptomatic, but some cases have been associated with precocious puberty, hypothermia, headache and/or obesity. Case presentation A 7-year-old boy was referred for short stature and proved to be partially growth-hormone deficient. Magnetic resonance imaging (MRI) revealed a lipoma in the paramedian hypothalamus. Growth hormone treatment resulted in swift and uncomplicated catch-up growth. Conclusions The present case appears to be the first to link hypothalamic lipoma to GH deficiency. The neuro-endocrine pathophysiology underpinning this link remains to be explored.
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Affiliation(s)
- Anne Rochtus
- 1Pediatric Neurology, University Hospitals Leuven, 3000 Leuven, Belgium.,2Pediatric Endocrinology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Joseph Vinckx
- 2Pediatric Endocrinology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Francis de Zegher
- 2Pediatric Endocrinology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
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