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Dusak A, Hafizoglu D, Kilic SS, Yazıcı Z. Central nervous system variations and abnormalities in anhidrotic ectodermal dysplasia (AED): neuroimaging findings. Acta Radiol 2020; 61:1377-1387. [PMID: 32000505 DOI: 10.1177/0284185120901510] [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] [Indexed: 11/15/2022]
Abstract
BACKGROUND Anhidrotic ectodermal dysplasia (AED) is a rare, mostly X-linked recessive genodermatosis, characterized by congenital defects of ectodermal derivative structures as the central nervous system (CNS) is primarily ectodermal in origin. PURPOSE To evaluate CNS variations and abnormalities in AED. MATERIAL AND METHODS A retrospective analysis was made of the neurological and neuroimaging findings of 17 children (12 boys, 5 girls; median age = 8 years; age range = 2-14 years) diagnosed with AED in our pediatric clinics during 2008-2016. The pattern of CNS variation and abnormalities were evaluated by comparing of these findings with an age- and gender-matched healthy control group with no family history. RESULTS Of the 17 AED cases identified on the basis of neuroimaging findings, 6 (35.3%) were seen to be normal. Associated CNS variation and abnormalities including cavum septum pellucidum (35.3%), callosal dysgenesis (11.8%), prominent Virchow-Robin spaces (64.7%), cortical sulcal dilation (41.1%), mega cisterna magna (35.3%), focal cortical dysplasia (11.8%), and delayed myelination (58.8%) were observed in 11 (64.7%) children with AED. CONCLUSION AED suggests a spectrum of CNS variation and abnormalities, presenting with neurological and neuroimaging findings, demonstrated in the embryonic surface- and neuro-ectoderm derived structures. The results of this study suggest that CNS variation and abnormalities might be associated with AED.
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Affiliation(s)
- Abdurrahim Dusak
- Department of Radiology, Uludag University, School of Medicine, Bursa, Turkey
| | - Demet Hafizoglu
- Department of Pediatrics, Uludag University, School of Medicine, Bursa, Turkey
| | - Sara Sebnem Kilic
- Department of Pediatrics, Uludag University, School of Medicine, Bursa, Turkey
| | - Zeynep Yazıcı
- Department of Radiology, Uludag University, School of Medicine, Bursa, Turkey
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Intracranial calcifications in childhood: Part 1. Pediatr Radiol 2020; 50:1424-1447. [PMID: 32734340 DOI: 10.1007/s00247-020-04721-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 04/03/2020] [Accepted: 05/12/2020] [Indexed: 12/30/2022]
Abstract
This article is the first of a two-part series on intracranial calcification in childhood. Intracranial calcification can be either physiological or pathological. Physiological intracranial calcification is not an expected neuroimaging finding in the neonatal or infantile period but occurs, as children grow older, in the pineal gland, habenula, choroid plexus and occasionally the dura mater. Pathological intracranial calcification can be broadly divided into infectious, congenital, endocrine/metabolic, vascular and neoplastic. The main goals in Part 1 are to discuss the chief differences between physiological and pathological intracranial calcification, to discuss the histological characteristics of intracranial calcification and how intracranial calcification can be detected across neuroimaging modalities, to emphasize the importance of age at presentation and intracranial calcification location, and to propose a comprehensive neuroimaging approach toward the differential diagnosis of the causes of intracranial calcification. Finally, in Part 1 the authors discuss the most common causes of infectious intracranial calcification, especially in the neonatal period, and congenital causes of intracranial calcification. Various neuroimaging modalities have distinct utilities and sensitivities in the depiction of intracranial calcification. Age at presentation, intracranial calcification location, and associated neuroimaging findings are useful information to help narrow the differential diagnosis of intracranial calcification. Intracranial calcification can occur in isolation or in association with other neuroimaging features. Intracranial calcification in congenital infections has been associated with clastic changes, hydrocephalus, chorioretinitis, white matter abnormalities, skull changes and malformations of cortical development. Infections are common causes of intracranial calcification, especially neonatal TORCH (toxoplasmosis, other [syphilis, varicella-zoster, parvovirus B19], rubella, cytomegalovirus and herpes) infections.
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Gupta S, Swarup MS, Singh S, Prakash A, Mehndiratta A, Garg A. Phakomatoses: A pictorial review. Indian J Radiol Imaging 2020; 30:195-205. [PMID: 33100689 PMCID: PMC7546286 DOI: 10.4103/ijri.ijri_497_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 02/11/2020] [Accepted: 04/09/2020] [Indexed: 01/13/2023] Open
Abstract
Phakomatoses or Neurocutaneous syndromes are a heterogeneous group of disorders and have variable inheritance pattern. Currently, more than 30 entities are included in this group. These disorders primarily affect the central nervous system; however, skin, viscera, and other connective tissues can also be involved with variable clinical presentation. We will describe and illustrate the various radiological findings of the common entities through the iconography of the cases presented to our department.
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Raus I, Coroiu RE, Capusan CS. Neuroimaging in pediatric phakomatoses. An educational review. Med Pharm Rep 2016; 89:56-64. [PMID: 27004026 PMCID: PMC4777470 DOI: 10.15386/cjmed-417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 06/25/2015] [Accepted: 07/06/2015] [Indexed: 12/30/2022] Open
Abstract
Phakomatoses are a group of more than 30 entities with an inheritance pattern that primarily affects the central nervous system, skin, viscera and connective tissue. The aim of this paper is to make an educational review of the most common radiological findings on phakomatoses through the iconography of the cases collected in our magnetic resonance imaging (MRI) and computer tomography (CT) units over the last ten years. Also, we describe and illustrate by these techniques the main features of the most common entities within the wide spectrum of diseases. As highly variable and age dependent, imaging techniques have an important role in the diagnosis and follow-up of these patients. Increased awareness for the need to implement and conduct screening programs could be considered as a solution to prevent late diagnosis and to treat the patients in early stages of disease.
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Affiliation(s)
- Iulian Raus
- Radiology Department, Dr. Constantin Papilian Military and Emergency Hospital of Cluj-Napoca, Romania
| | - Roxana Elena Coroiu
- Radiology Department, Iuliu Hatieganu University of Medicine and Pharmacy of Cluj-Napoca, Romania
| | - Cosmin Serban Capusan
- Radiology Department, Dr. Constantin Papilian Military and Emergency Hospital of Cluj-Napoca, Romania
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Barbier C, Chabernaud C, Barantin L, Bertrand P, Sembely C, Sirinelli D, Castelnau P, Cottier JP. Proton MR spectroscopic imaging of basal ganglia and thalamus in neurofibromatosis type 1: correlation with T2 hyperintensities. Neuroradiology 2010; 53:141-8. [PMID: 20959972 DOI: 10.1007/s00234-010-0776-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2010] [Accepted: 09/23/2010] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Neurofibromatosis type 1 (NF1) is frequently associated with hyperintense lesions on T2-weighted images called "unidentified bright objects" (UBO). To better characterize the functional significance of UBO, we investigate the basal ganglia and thalamus using spectroscopic imaging in children with NF1 and compare the results to anomalies observed on T2-weighted images. METHODS Magnetic resonance (MR) data of 25 children with NF1 were analyzed. On the basis of T2-weighted images analysis, two groups were identified: one with normal MR imaging (UBO- group; n = 10) and one with UBO (UBO+ group; n = 15). Within the UBO+ group, a subpopulation of patients (n = 5) only had lesions of the basal ganglia. We analyzed herein seven regions of interest (ROIs) for each side: caudate nucleus, capsulo-lenticular region, lateral and posterior thalamus, thalamus (lateral and posterior voxels combined), putamen, and striatum. For each ROI, a spectrum of the metabolites and their ratio was obtained. RESULTS Patients with abnormalities on T2-weighted images had significantly lower NAA/Cr, NAA/Cho, and NAA/mI ratios in the lateral right thalamus compared with patients with normal T2. These abnormal spectroscopic findings were not observed in capsulo-lenticular regions that had UBO but in the thalamus region that was devoid of UBO. CONCLUSION Multivoxel spectroscopic imaging using short-time echo showed spectroscopic abnormalities in the right thalamus of NF1 patients harboring UBO, which were mainly located in the basal ganglia. This finding could reflect the anatomical and functional interactions of these regions.
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Affiliation(s)
- Charlotte Barbier
- Department of Neuroradiology, CHRU & Tours University, Tours 37000, France
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Provenzale JM. Imaging findings of structural causes of epilepsy in children: a guide for the radiologist in the emergency room. Emerg Radiol 2010; 17:479-86. [PMID: 20596745 DOI: 10.1007/s10140-010-0884-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2010] [Accepted: 06/14/2010] [Indexed: 11/26/2022]
Abstract
Evaluation of the child with epilepsy is a relatively common indication for imaging in the emergency room setting. This room outlines some of the more important imaging features of causes of epilepsy in children.
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Affiliation(s)
- James M Provenzale
- Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA.
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McErlean A, Abdalla K, Donoghue V, Ryan S. The dentate nucleus in children: normal development and patterns of disease. Pediatr Radiol 2010; 40:326-39. [PMID: 20107778 DOI: 10.1007/s00247-009-1504-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2009] [Revised: 11/17/2009] [Accepted: 11/22/2009] [Indexed: 12/01/2022]
Abstract
The dentate nuclei lie deep within the cerebellum and play a vital role in the pathways involved in fine motor control and coordination. They are susceptible to a variety of diseases. Some pathological processes preferentially affect the dentate nuclei, while concomitant basal ganglia or white matter involvement can be a striking finding in others. A familiarity with the normal appearance of the dentate nuclei at different ages in combination with the radiological distribution of pathology in the brain allows the paediatric radiologist to develop a logical approach to the interpretation of MR imaging of these deep cerebellar nuclei. In this article we review the normal appearance and MR features of the dentate nuclei, including changes that are seen with myelination. We describe the specific imaging characteristics of childhood diseases that involve the dentate nuclei, and develop a systematic approach to the differential diagnosis of dentate nucleus abnormalities on MR imaging.
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Affiliation(s)
- Aoife McErlean
- Radiology Department, Children's University Hospital, Dublin 1, Ireland.
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Jensen L, Heath KJ, Scott G, Byard RW. Sudden death and the forensic evaluation of neurocutaneous syndromes. J Forensic Leg Med 2009; 16:369-74. [DOI: 10.1016/j.jflm.2009.04.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2008] [Accepted: 04/02/2009] [Indexed: 01/19/2023]
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Indium-111 Pentetreotide Uptake Within Cerebellar Hemangioblastoma in Von Hippel-Lindau Syndrome. Clin Nucl Med 2008; 33:294-6. [DOI: 10.1097/rlu.0b013e3181662bf9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Jurkiewicz E, Jóźwiak S, Bekiesińska-Figatowska M, Pakieła-Domańska D, Pakuła-Kościesza I, Walecki J. Cerebellar lesions in children with tuberous sclerosis complex. Neuroradiol J 2006; 19:577-82. [PMID: 24351257 DOI: 10.1177/197140090601900503] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2006] [Accepted: 10/08/2006] [Indexed: 01/05/2023] Open
Abstract
Cerebellar lesions in tuberous sclerosis complex are less frequent than cerebral findings. We present the magnetic resonance (MR) features of uncommon cerebellar changes found in a large series of children with tuberous sclerosis complex (TSC). MR examinations of 73 children (38 males and 35 females) with TSC were reviewed. Twelve patients with cerebellar lesions were selected. Patients' ages ranged from 2.5 years to 21.25 (median: 10.6). The number, anatomic location, signal intensity and contrast enhancement of these lesions were evaluated. MR studies were performed with a 1.5 T scanner obtaining T1, T2-weighted images and FLAIR sequences. Gadolinium was administrated in all cases. Cerebellar tubers were found in 12 patients (16.4%). The total number of cerebellar tubers was 21. Most cerebellar tubers were hyperintense on T2-weighted and FLAIR images and slightly hypointense on T1-weighted images. Eleven of these lesions (52.38%) revealed contrast enhancement. None of cortical cerebral tubers showed contrast enhancement. Atrophy of seven cerebellar tubers was noticed. The mutation in TSC2 gene was confirmed in eight patients. Cerebellar tubers are uncommon. They were not found in the absence of cerebral tubers and may associated with parenchymal volume loss.
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Affiliation(s)
- E Jurkiewicz
- MR Unit, The Children's Memorial Health Institute; Warsaw, Poland -
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Abstract
In this article, we develop an approach to the headache patient based upon pattern of headache. Headache can be acute recurrent, acute, chronic progressive, and chronic nonprogressive. Within each pattern we go through the differential diagnosis, with a focus on secondary causes of headache. Although most patients presenting with headache will end up having migraine, we must be able to recognize the other causes when they present.
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Affiliation(s)
- Jack Gladstein
- Department of Pediatrics and Neurology, Pediatric Headache Clinic, University of Maryland School of Medicine, 22 South Greene Street, Room N5W69, Baltimore, MD 21201, USA.
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Jones J, Brenner C, Chinn R, Bunker CB. Radiological associations with dermatological disease. Br J Radiol 2005; 78:662-71. [PMID: 15961854 DOI: 10.1259/bjr/66219766] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Skin disease and its treatment may have radiological connotations. Though this article is not a comprehensive account of dermatological and radiological associations, it provides an eclectic selection of some common and some rare clinical entities, which the practicing radiologist may recognize or remember.
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Affiliation(s)
- J Jones
- Department of Dermatology, Chelsea and Westminster Hospital, London, UK
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Kremer S, Schmitt E, Klein O, Vignal JP, Moret C, Kahane P, Arzimanoglou A. Leptomeningeal Enhancement and Enlarged Choroid Plexus Simulating the Appearance of Sturge-Weber Disease in a Child with Tuberous Sclerosis. Epilepsia 2005; 46:595-6. [PMID: 15816960 DOI: 10.1111/j.0013-9580.2005.62704.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Affiliation(s)
- Erhan Akpinar
- Department of Radiology, Hacettepe University, 06100 Sihhiye, Ankara, Turkey.
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Tseng BS, Haas-Kogan D. Neurocutaneous Syndromes and Associated CNS Tumors. PEDIATRIC ONCOLOGY 2004. [DOI: 10.1007/978-3-662-09227-9_12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Gajeski BL, Kettner NW, Awwad EE, Boesch RJ. Neurofibromatosis type I: clinical and imaging features of Von Recklinghausen's disease. J Manipulative Physiol Ther 2003; 26:116-27. [PMID: 12584510 DOI: 10.1067/mmt.2003.7] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To discuss the case of a 45-year-old woman, with a prior diagnosis of neurofibromatosis type 1 (NF-1), complaining of low back and cervical spine pain with bilateral upper extremity paresthesias. CLINICAL FEATURES The patient had a dull, achy, constant low-back pain of 4 months' duration, with mild headaches and upper extremity paresthesias. Multiple skin lesions and spinopelvic postural imbalances were present. Diagnostic radiography, along with advanced imaging, demonstrated multilevel dysplastic osseous changes, with dural ectasia, scoliosis, and tumor extension. In addition to the previous diagnosis of NF-1, our clinical diagnosis included segmental dysfunction with resultant cervicalgia, lumbalgia, and myospasm. INTERVENTION AND OUTCOME Treatment consisted of a course of spinal manipulation of the lumbopelvic region, with adjunctive therapy consisting of interferential therapy, heat, and rehabilitative exercise. Marked reduction in pain and paresthesia with improved function were achieved. CONCLUSIONS NF-1 is a multisystem disease with neoplasia of the skin and nervous system. Patients experience a lifetime of morbidity and increased risk of mortality, depending on the extent of the disease. A multitude of therapeutic regimens may be engaged to improve NF-1-associated symptomatology and morbidity. Chiropractic spinal manipulation may have a positive effect in pain reduction and improved function in patients who have NF-1 without spinal instability.
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Affiliation(s)
- Brooke L Gajeski
- Department of Radiology, Logan College of Chiropractic, Chesterfield, MO 63006, USA.
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A reply. Clin Radiol 2000; 55:986-7. [PMID: 11124088 DOI: 10.1053/crad.2000.0432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Curtis, J. and Lewis-Jones, H. (2000). Clinical Radiology55, 984-985. Copyright 2000 The Royal College of Radiologists.
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Brochwicz-Lewinski M, Patel D. Tuberous Sclerosis. J R Coll Physicians Edinb 2000. [DOI: 10.1177/147827150003000304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
| | - D. Patel
- Department of Radiology, Royal Infirmary of Edinburgh
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