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Imaging in the study of macrocephaly: Why?, when?, how? RADIOLOGIA 2022; 64:26-40. [DOI: 10.1016/j.rxeng.2021.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 09/10/2021] [Indexed: 11/19/2022]
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Schonstedt Geldres V, Stecher Guzmán X, Manterola Mordojovich C, Rovira À. Radiología en el estudio de la macrocefalia. ¿Por qué?, ¿cuándo?, ¿cómo? RADIOLOGIA 2022. [DOI: 10.1016/j.rx.2021.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Guzik A, Perenc L, Drużbicki M, Podgórska-Bednarz J. Abnormal cranium development in children and adolescents affected by syndromes or diseases associated with neurodysfunction. Sci Rep 2021; 11:2908. [PMID: 33536524 PMCID: PMC7859185 DOI: 10.1038/s41598-021-82511-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 01/21/2021] [Indexed: 12/21/2022] Open
Abstract
Microcephaly and macrocephaly can be considered both cranial growth defects and clinical symptoms. There are two assessment criteria: one applied in dysmorphology and another conventionally used in clinical practice. The determination of which definition or under which paradigm the terminology should be applied can vary on a daily basis and from case to case as necessity dictates, as can defining the relationship between microcephaly or macrocephaly and syndromes or diseases associated with neurodysfunction. Thus, there is a need for standardization of the definition of microcephaly and macrocephaly. This study was designed to investigate associations between abnormal cranial development (head size) and diseases or syndromes linked to neurodysfunction based on essential data collected upon admission of patients to the Neurological Rehabilitation Ward for Children and Adolescents in Poland. The retrospective analysis involved 327 children and adolescents with medical conditions associated with neurodysfunction. Two assessment criteria were applied to identify subgroups of patients with microcephaly, normal head size, and macrocephaly: one system commonly used in clinical practice and another applied in dysmorphology. Based on the results, children and adolescents with syndromes or diseases associated with neurodysfunction present abnormal cranial development (head size), and microcephaly rarely co-occurs with neuromuscular disease. Macrocephaly frequently co-occurs with neural tube defects or neuromuscular diseases and rarely with cerebral palsy (p < 0.05); microcephaly frequently co-occurs with epilepsy and hypothyroidism (p < 0.001). Traditional classification facilitates the identification of a greater number of relationships and is therefore recommended for use in daily practice. There is a need to standardize the definition of microcephaly and macrocephaly and to include them in 'Human Phenotype Ontology' terms.
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Affiliation(s)
- Agnieszka Guzik
- Department of Physiotherapy, Institute of Health Sciences, College of Medical Sciences, University of Rzeszów, Rzeszów, Poland.
| | - Lidia Perenc
- Department of Physiotherapy, Institute of Health Sciences, College of Medical Sciences, University of Rzeszów, Rzeszów, Poland
| | - Mariusz Drużbicki
- Department of Physiotherapy, Institute of Health Sciences, College of Medical Sciences, University of Rzeszów, Rzeszów, Poland
| | - Justyna Podgórska-Bednarz
- Department of Physiotherapy, Institute of Health Sciences, College of Medical Sciences, University of Rzeszów, Rzeszów, Poland
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Sherman ML, Close S, Weselman B. Dandy-Walker Malformation: A Case Study of an Infant With an Increasing Head Circumference and Delayed Developmental Milestones. J Pediatr Health Care 2017; 31:398-403. [PMID: 28017487 DOI: 10.1016/j.pedhc.2016.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 11/23/2016] [Accepted: 11/28/2016] [Indexed: 10/20/2022]
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Naffaa L, Rubin M, Stamler AC, Haddad M, Saade C. The diagnostic yield of ultrasound of the head in healthy infants presenting with the clinical diagnosis of benign macrocrania. Clin Radiol 2016; 72:94.e7-94.e11. [PMID: 27756452 DOI: 10.1016/j.crad.2016.08.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 08/12/2016] [Accepted: 08/31/2016] [Indexed: 10/20/2022]
Abstract
AIM To investigate the frequency of sonographic findings that required neurosurgical consultation for all referred outpatients suspected to have benign macrocrania (BMC). MATERIALS AND METHODS A retrospective review was performed from September 2011 until June 2015 for all outpatients referred to the ultrasound (US) department for BMC. Electronic medical records, US images, and reports were reviewed in conjunction with follow-up imaging. Each review consisted of gender, specialty of referring physician, first head circumference, head circumference at or closest to the time of the head US, the last head circumference, and any neurological issue prior to the US, at the time of US, or following the US, and clinical outcomes. Statistical analysis employed the Kruskal-Wallis rank sum test and Fischer's exact test (chi square test of independence) that compared normal/BMC patients from the patients requiring a neurosurgical consultation. RESULTS One hundred and thirty (40.9%) had a normal head US, 181 patients (56.9%) had sonographic findings of BMC, and seven (2.2%) patients had an abnormal head US that required a neurosurgical consultation. Of the 181 patients with BMC, 23 underwent follow-up imaging with 22 patients having unchanged BMC or a normal head US and one patient developing mild ventriculomegaly that was stable on follow-up imaging. Three of the seven patients (1%) aged 1.8, 2.3, and 13.1 months with abnormal head US requiring neurosurgical consultation, had mild ventriculomegaly that was stable on follow-up imaging. Four of the seven patients (1.2%) that required neurosurgical consultation needed a neurosurgical procedure. Between the two US subgroups (normal and BMC), no statistical significance was noted regarding age of patient at US, head circumference at clinical and radiological presentation (p>0.05) except for the first head circumference clinically documented which demonstrated statistical significance (p<0.03). CONCLUSION Short interval surveillance including head circumference and assessment for the development of bulging anterior fontanelle and neurological abnormalities may be more cost effective than US in the initial evaluation of patients clinically suspected to have BMC.
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Affiliation(s)
- L Naffaa
- Diagnostic Radiology Department, American University of Beirut Medical Center, P.O. Box: 11-0236 Riad El-Solh, Beirut, 1107 2020, Lebanon.
| | - M Rubin
- Diagnostic Radiology Department, Akron Children's Hospital, One Perkins Square Akron, Ohio 44308, USA
| | - A C Stamler
- Diagnostic Radiology Department, Akron Children's Hospital, One Perkins Square Akron, Ohio 44308, USA
| | - M Haddad
- Diagnostic Radiology Department, American University of Beirut Medical Center, P.O. Box: 11-0236 Riad El-Solh, Beirut, 1107 2020, Lebanon
| | - C Saade
- Diagnostic Radiology Department, American University of Beirut Medical Center, P.O. Box: 11-0236 Riad El-Solh, Beirut, 1107 2020, Lebanon
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Radoš M, Klarica M, Mučić-Pucić B, Nikić I, Raguž M, Galkowski V, Mandić D, Orešković D. Volumetric analysis of cerebrospinal fluid and brain parenchyma in a patient with hydranencephaly and macrocephaly--case report. Croat Med J 2015; 55:388-93. [PMID: 25165052 PMCID: PMC4157378 DOI: 10.3325/cmj.2014.55.388] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The aim of this study was to perform for the first time the intracranial volumetric analysis of cerebrospinal fluid (CSF) and brain parenchyma in the supratentorial and infratentorial space in a 30-year-old female patient with hydranencephaly and macrocephaly. A head scan performed using a 3T magnetic resonance was followed by manual segmentation of the brain parenchyma and CSF on T2 coronal brain sections. The volume of CSF and brain parenchyma was measured separately for the supratentorial and infratentorial space. The total volume of the intracranial space was 3645.5 cm3. In the supratentorial space, the volume of CSF was 3375.2 cm3 and the volume of brain parenchyma was 80.3 cm3. In the infratentorial space, the volume of CSF was 101.3 cm3 and the volume of the brain parenchyma was 88.7 cm3. In the supratentorial space, there was severe malacia of almost all brain parenchyma with no visible remnants of the choroid plexuses. Infratentorial structures of the brainstem and cerebellum were hypoplastic but completely developed. Since our patient had no choroid plexuses in the supratentorial space and no obstruction between dural sinuses and CSF, development of hydrocephalus and macrocephaly cannot be explained by the classic hypothesis of CSF physiology with secretion, unidirectional circulation, and absorption as its basic postulates. However, the origin and turnover of the enormous amount of intracranial CSF volume, at least 10-fold larger than normal, and the mechanisms of macroencephaly development could be elucidated by the new hypothesis of CSF physiology recently published by our research team.
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Affiliation(s)
| | - Marijan Klarica
- Marijan Klarica, University of Zagreb, School of Medicine, Department of Pharmacology and Croatian Institute for Brain Research, Šalata 11, 10 000 Zagreb, Croatia,
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Abu-Arafeh I, Howells R. Primary Headaches in Children Under the Age of 7 Years. Curr Pain Headache Rep 2014; 18:401. [DOI: 10.1007/s11916-013-0401-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Chen CC, Lin KL, Chen CL, Wong AMK, Huang JL. Central nervous system manifestations of neonatal lupus: a systematic review. Lupus 2013; 22:1484-8. [PMID: 24142583 DOI: 10.1177/0961203313509294] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Neonatal lupus is a rare and acquired autoimmune disease. Central nervous system abnormalities are potential manifestations in neonatal lupus. Through a systematic literature review, we analyzed the clinical features of previously reported neonatal lupus cases where central nervous system abnormalities had been identified. Most reported neonatal lupus patients with central nervous system involvement were neuroimaging-determined and asymptomatic. Only seven neonatal lupus cases were identified as having a symptomatic central nervous system abnormality which caused physical disability or required neurosurgery. A high percentage of these neurosymptomatic neonatal lupus patients had experienced a transient cutaneous skin rash and had no maternal history of autoimmune disease before pregnancy.
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Affiliation(s)
- C C Chen
- 1Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan, Taiwan
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Glaser KJ, Manduca A, Ehman RL. Review of MR elastography applications and recent developments. J Magn Reson Imaging 2012; 36:757-74. [PMID: 22987755 PMCID: PMC3462370 DOI: 10.1002/jmri.23597] [Citation(s) in RCA: 170] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The technique of MR elastography (MRE) has emerged as a useful modality for quantitatively imaging the mechanical properties of soft tissues in vivo. Recently, MRE has been introduced as a clinical tool for evaluating chronic liver disease, but many other potential applications are being explored. These applications include measuring tissue changes associated with diseases of the liver, breast, brain, heart, and skeletal muscle including both focal lesions (e.g., hepatic, breast, and brain tumors) and diffuse diseases (e.g., fibrosis and multiple sclerosis). The purpose of this review article is to summarize some of the recent developments of MRE and to highlight some emerging applications.
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Affiliation(s)
| | - Armando Manduca
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA
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McMullen AB, Baidwan GS, McCarthy KD. Morphological and behavioral changes in the pathogenesis of a novel mouse model of communicating hydrocephalus. PLoS One 2012; 7:e30159. [PMID: 22291910 PMCID: PMC3265463 DOI: 10.1371/journal.pone.0030159] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2011] [Accepted: 12/14/2011] [Indexed: 11/18/2022] Open
Abstract
The Ro1 model of hydrocephalus represents an excellent model for studying the pathogenesis of hydrocephalus due to its complete penetrance and inducibility, enabling the investigation of the earliest cellular and histological changes in hydrocephalus prior to overt pathology. Hematoxylin and eosin staining, immunofluorescence and electron microscopy were used to characterize the histopathological events of hydrocephalus in this model. Additionally, a broad battery of behavioral tests was used to investigate behavioral changes in the Ro1 model of hydrocephalus. The earliest histological changes observed in this model were ventriculomegaly and disorganization of the ependymal lining of the aqueduct of Sylvius, which occurred concomitantly. Ventriculomegaly led to thinning of the ependyma, which was associated with periventricular edema and areas of the ventricular wall void of cilia and microvilli. Ependymal denudation was subsequent to severe ventriculomegaly, suggesting that it is an effect, rather than a cause, of hydrocephalus in the Ro1 model. Additionally, there was no closure of the aqueduct of Sylvius or any blockages within the ventricular system, even with severe ventriculomegaly, suggesting that the Ro1 model represents a model of communicating hydrocephalus. Interestingly, even with severe ventriculomegaly, there were no behavioral changes, suggesting that the brain is able to compensate for the structural changes that occur in the pathogenesis of hydrocephalus if the disorder progresses at a sufficiently slow rate.
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MESH Headings
- Animals
- Behavior, Animal/physiology
- Brain/pathology
- Brain/physiopathology
- Brain/ultrastructure
- Cardiomegaly/pathology
- Cerebral Aqueduct/pathology
- Cerebral Aqueduct/ultrastructure
- Cerebral Ventricles/pathology
- Cerebral Ventricles/ultrastructure
- Disease Models, Animal
- Hydrocephalus/complications
- Hydrocephalus/genetics
- Hydrocephalus/pathology
- Hydrocephalus/physiopathology
- Mice
- Mice, Inbred C57BL
- Mice, Transgenic
- Microscopy, Electron
- Receptors, Opioid, kappa/genetics
- Receptors, Opioid, kappa/metabolism
- Receptors, Opioid, kappa/physiology
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Affiliation(s)
- Allison B. McMullen
- Department of Pharmacology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Gurlal S. Baidwan
- Department of Pharmacology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Ken D. McCarthy
- Department of Pharmacology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- * E-mail:
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Zahl SM, Egge A, Helseth E, Wester K. Benign external hydrocephalus: a review, with emphasis on management. Neurosurg Rev 2011; 34:417-32. [PMID: 21647596 PMCID: PMC3171652 DOI: 10.1007/s10143-011-0327-4] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2010] [Revised: 04/18/2011] [Accepted: 05/01/2011] [Indexed: 11/10/2022]
Abstract
Benign external hydrocephalus in infants, characterized by macrocephaly and typical neuroimaging findings, is considered as a self-limiting condition and is therefore rarely treated. This review concerns all aspects of this condition: etiology, neuroimaging, symptoms and clinical findings, treatment, and outcome, with emphasis on management. The review is based on a systematic search in the Pubmed and Web of Science databases. The search covered various forms of hydrocephalus, extracerebral fluid, and macrocephaly. Studies reporting small children with idiopathic external hydrocephalus were included, mostly focusing on the studies reporting a long-term outcome. A total of 147 studies are included, the majority however with a limited methodological quality. Several theories regarding pathophysiology and various symptoms, signs, and clinical findings underscore the heterogeneity of the condition. Neuroimaging is important in the differentiation between external hydrocephalus and similar conditions. A transient delay of psychomotor development is commonly seen during childhood. A long-term outcome is scarcely reported, and the results are varying. Although most children with external hydrocephalus seem to do well both initially and in the long term, a substantial number of patients show temporary or permanent psychomotor delay. To verify that this truly is a benign condition, we suggest that future research on external hydrocephalus should focus on the long-term effects of surgical treatment as opposed to conservative management.
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Affiliation(s)
- Sverre Morten Zahl
- Department of Neurosurgery, Haukeland University Hospital, Bergen, Norway.
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Kim JH, Lee CH, Hwang SH, Kang DH. Superimposed propionibacterium acnes subdural empyema in a patient with chronic subdural hematoma. J Korean Neurosurg Soc 2009; 45:53-6. [PMID: 19242574 DOI: 10.3340/jkns.2009.45.1.53] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2008] [Accepted: 12/29/2008] [Indexed: 11/27/2022] Open
Abstract
The authors present a case of subdural empyema in a macrocephalic patient. A 23-year-old male was admitted due to headache and fever. One month ago, he had mild head injury by his coworkers. Physical examination showed a macrocephaly and laboratory findings suggested purulent meningitis. Neuroimaging studies revealed a huge size of epidural space-occupying lesion. Under the impression of epidural abscess, operation was performed. Eventually, the lesion was located at subdural space and was proven to be subdural empyema. Later, histological examination of the specimen obtained by surgery demonstrated finings consistent with the capsule of the chronic subdural hematoma. Two weeks after operation, Propionibacterium acnes was isolated. The intravenous antibiotics were used for total of eight weeks under monitoring of the serum level of the C-reactive protein. Follow-up brain computed tomography (CT) scan showed the presence of significant amount of remaining subdural lesion. However, he has complained of minimal discomfort. It is suggested that the subdural empyema occurred with preexisting chronic subdural hematoma after head injury about one month prior to admission and it took a long time to treat Propionibacterium acnes subdural empyema with systemic antibiotics, at least over eight weeks.
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Affiliation(s)
- Jong Hun Kim
- Department of Neurosurgery, Gyeongsang National University School of Medicine, Jinju, Korea
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