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Published in: Child's Nervous System 10/2021

01-10-2021 | Hydrocephalus | Case Report

Tectocerebellar dysraphia and occipital encephalocele associated with trisomy X: case report and review of the literature

Authors: Lissa C. Goulart, Luiz A. Ferreira-Filho, Mariana M. da Silva, Israel S. B. Carneiro, Siderley S. Carneiro, Osvaldo Vilela-Filho

Published in: Child's Nervous System | Issue 10/2021

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Abstract

Introduction

Tectocerebellar dysraphia (TCD) is a rare sporadic malformation associated with severe neurodevelopmental morbidity and high infant mortality. The presence of other ciliopathies worsens the prognosis. Joubert syndrome (JS) is a ciliopathy associated with gene mutations, consisting of midbrain and cerebellum malformations, markedly lack fiber decussation at the level of the pontomesencephalic junction.

Case report

We report the case of a child who was born term with occipital encephalocele (OE), diagnosed with TCD and JS spectrum through computed tomography (CT), magnetic resonance (MR), diffuse tensor imaging (DTI), and clinical findings. She had the OE surgically corrected after spontaneous rupture on the second day after delivery. She developed postoperative ventriculitis, meningitis, and hydrocephalus, successfully treated with intravenous antibiotics and cysto-ventriculostomy, cysto-cisternostomy, third ventriculostomy, and choroid plexus coagulation. G-band karyotyping showed 47, XXX, in all analyzed cells (trisomy X). The infant was followed up for 18 months, presenting, so far, a relatively good outcome.

Conclusion

This is the first case reported in the literature of the association of TCD/OE/JS spectrum (JSS) with trisomy X (XXX).
Literature
1.
go back to reference Padget DH, Lindenberg R (1972) Inverse cerebellum morphogenetically to Dandy-Walker and Arnold-Chiari syndromes: bizarre malformed brain with occipital encephalocele. Johns Hopkins Med J 131(3):228–246PubMed Padget DH, Lindenberg R (1972) Inverse cerebellum morphogenetically to Dandy-Walker and Arnold-Chiari syndromes: bizarre malformed brain with occipital encephalocele. Johns Hopkins Med J 131(3):228–246PubMed
2.
go back to reference Friede RL (1978) Uncommon syndromes of cerebellar vermis aplasia. II: tectocerebellar dysraphia with occipital encephalocele. Dev Med Child Neurol 20(6):764–772CrossRef Friede RL (1978) Uncommon syndromes of cerebellar vermis aplasia. II: tectocerebellar dysraphia with occipital encephalocele. Dev Med Child Neurol 20(6):764–772CrossRef
3.
go back to reference Martinez-Lage JF, Poza M, Sola J, Soler CL, Montalvo CG, Domingo R et al (1996) The child with a cephalocele: etiology, neuroimaging, and outcome. Childs Nerv Syst 12(9):540–550CrossRef Martinez-Lage JF, Poza M, Sola J, Soler CL, Montalvo CG, Domingo R et al (1996) The child with a cephalocele: etiology, neuroimaging, and outcome. Childs Nerv Syst 12(9):540–550CrossRef
4.
go back to reference Anik I, Koc K, Anik Y, Yildiz DK, Ceilan S (2010) Tectocerebellar dysraphism with vermian encephalocele. J Child Neurol 25(11):1411–1414CrossRef Anik I, Koc K, Anik Y, Yildiz DK, Ceilan S (2010) Tectocerebellar dysraphism with vermian encephalocele. J Child Neurol 25(11):1411–1414CrossRef
5.
go back to reference Timur H, Sanhal CY, Tokmak A, Muftuoglu KH, Danisman N (2015) Prenatal diagnosis of tectocerebellar dysraphia with occipital encephalocele. J Clin Diagn Res 9(12):QD05–QD07PubMedPubMedCentral Timur H, Sanhal CY, Tokmak A, Muftuoglu KH, Danisman N (2015) Prenatal diagnosis of tectocerebellar dysraphia with occipital encephalocele. J Clin Diagn Res 9(12):QD05–QD07PubMedPubMedCentral
6.
go back to reference Poretti A, Singhi S, Huisman TA, Meoded A, Jallo G, Ozturk A, Boltshauser E (2011) Tecto-cerebellar dysraphism with occipital encephalocele: not a distinct disorder, but part of the Joubert syndrome spectrum? Neuropediatrics 42(4):170–174CrossRef Poretti A, Singhi S, Huisman TA, Meoded A, Jallo G, Ozturk A, Boltshauser E (2011) Tecto-cerebellar dysraphism with occipital encephalocele: not a distinct disorder, but part of the Joubert syndrome spectrum? Neuropediatrics 42(4):170–174CrossRef
7.
go back to reference Shekdar K (2011) Posterior fossa malformations. Semin Ultrasound CT MR 32(3):228–241CrossRef Shekdar K (2011) Posterior fossa malformations. Semin Ultrasound CT MR 32(3):228–241CrossRef
8.
go back to reference Demaerel P, Kendall BE, Wilms G, Halpin SFS, Casaer P, Baert AL (1995) Uncommon posterior cranial fossa anomalies: MRI with clinical correlation. Neuroradiology 37(1):72–76CrossRef Demaerel P, Kendall BE, Wilms G, Halpin SFS, Casaer P, Baert AL (1995) Uncommon posterior cranial fossa anomalies: MRI with clinical correlation. Neuroradiology 37(1):72–76CrossRef
9.
go back to reference Ginat DT, Reid R, Frim DM (2016) Imaging assessment of re-exploratory repair of an occipital bone defect-associated tectocerebellar dysraphism via hybrid cranioplasty. Pediatr Neurosurg 51(3):164–166CrossRef Ginat DT, Reid R, Frim DM (2016) Imaging assessment of re-exploratory repair of an occipital bone defect-associated tectocerebellar dysraphism via hybrid cranioplasty. Pediatr Neurosurg 51(3):164–166CrossRef
10.
go back to reference Naidich TP, Altman NR, Braffman BH, McLone DG, Zimmerman RA (1992) Cephaloceles and related malformations. AJNR Am J Neuroradiol 13(2):655–690PubMedPubMedCentral Naidich TP, Altman NR, Braffman BH, McLone DG, Zimmerman RA (1992) Cephaloceles and related malformations. AJNR Am J Neuroradiol 13(2):655–690PubMedPubMedCentral
11.
go back to reference Takanashi J, Sugita K, Barkovich AJ, Takano H, Kohno Y (1999) Partial midline fusion of the cerebellar hemispheres with vertical folia: a new cerebellar malformation? AJNR Am J Neuroradiol 20(6):1151–1153PubMedPubMedCentral Takanashi J, Sugita K, Barkovich AJ, Takano H, Kohno Y (1999) Partial midline fusion of the cerebellar hemispheres with vertical folia: a new cerebellar malformation? AJNR Am J Neuroradiol 20(6):1151–1153PubMedPubMedCentral
12.
go back to reference Chowdhary UM, Ibrahim AW, Ammar AS, Dawodu AH (1989) Tecto-cerebellar dysraphia with occipital encephalocele. Surg Neurol 31(4):310–314CrossRef Chowdhary UM, Ibrahim AW, Ammar AS, Dawodu AH (1989) Tecto-cerebellar dysraphia with occipital encephalocele. Surg Neurol 31(4):310–314CrossRef
13.
go back to reference Dehdashti AR, Abouzeid H, Momjian S, Delavelle J, Rilliet B (2004) Occipital extra- and intracranial lipoencephalocele associated with tectocerebellar dysraphia. Childs Nerv Syst 20(4):225–228CrossRef Dehdashti AR, Abouzeid H, Momjian S, Delavelle J, Rilliet B (2004) Occipital extra- and intracranial lipoencephalocele associated with tectocerebellar dysraphia. Childs Nerv Syst 20(4):225–228CrossRef
14.
go back to reference Agrawal A, Joharapurkar SR, Khan AU (2010) Tectocerebellar dysraphia manifesting as occipital meningocele associated with congenital melanocytic nevi and pectus excavatum. Iran J Pediatr 20(1):118–122PubMedPubMedCentral Agrawal A, Joharapurkar SR, Khan AU (2010) Tectocerebellar dysraphia manifesting as occipital meningocele associated with congenital melanocytic nevi and pectus excavatum. Iran J Pediatr 20(1):118–122PubMedPubMedCentral
15.
go back to reference Nicolas-Jilwan M, Al-Ahmari AN, Alowain MA, Altuhaini KS, Alshail EA (2019) Tectocerebellar dysraphia with occipital encephalocele: a phenotypic variant of the TMEM231 gene mutation induced Joubert syndrome. Childs Nerv Syst 35(7):1257–1261CrossRef Nicolas-Jilwan M, Al-Ahmari AN, Alowain MA, Altuhaini KS, Alshail EA (2019) Tectocerebellar dysraphia with occipital encephalocele: a phenotypic variant of the TMEM231 gene mutation induced Joubert syndrome. Childs Nerv Syst 35(7):1257–1261CrossRef
16.
go back to reference Roosing S, Romani M, Isrie M, Rosti RO, Micalizzi A, Musaey D et al (2016) Mutations in CEP120 cause Joubert syndrome as well as complex ciliopathy phenotypes. J Med Genet 53(9):608–615CrossRef Roosing S, Romani M, Isrie M, Rosti RO, Micalizzi A, Musaey D et al (2016) Mutations in CEP120 cause Joubert syndrome as well as complex ciliopathy phenotypes. J Med Genet 53(9):608–615CrossRef
17.
go back to reference Leibovitz Z, Mandel H, Falik-Zaccai TC, Harouch SB, Savitzki D, Krajden-Haratz K et al (2017) Walker-Warburg syndrome and tectocerebellar dysraphia: a novel association caused by a homozygous DAG1 mutation. Eur J Paediatr Neurol 22(3):525–531CrossRef Leibovitz Z, Mandel H, Falik-Zaccai TC, Harouch SB, Savitzki D, Krajden-Haratz K et al (2017) Walker-Warburg syndrome and tectocerebellar dysraphia: a novel association caused by a homozygous DAG1 mutation. Eur J Paediatr Neurol 22(3):525–531CrossRef
18.
go back to reference Hildebrandt F, Benzing T, Katsanis N (2011) Ciliopathies. N Engl J Med 364(16):1533–1543CrossRef Hildebrandt F, Benzing T, Katsanis N (2011) Ciliopathies. N Engl J Med 364(16):1533–1543CrossRef
20.
go back to reference Widjaja E, Blaser S, Raybaud C (2006) Diffusion tensor imaging of midline posterior fossa malformations. Pediatr Radiol 36(6):510–517CrossRef Widjaja E, Blaser S, Raybaud C (2006) Diffusion tensor imaging of midline posterior fossa malformations. Pediatr Radiol 36(6):510–517CrossRef
21.
go back to reference Lee SK, Dong IK, Kim J, Dong JK, Heung DK, Dong SK, Susumu M (2005) Diffusion-tensor MR imaging and fiber tractography: a new method of describing aberrant fiber connections in developmental CNS anomalies. Radiographics 25(1):53–65CrossRef Lee SK, Dong IK, Kim J, Dong JK, Heung DK, Dong SK, Susumu M (2005) Diffusion-tensor MR imaging and fiber tractography: a new method of describing aberrant fiber connections in developmental CNS anomalies. Radiographics 25(1):53–65CrossRef
22.
go back to reference Poretti A, Boltshauser E, Loenneker T, Valente EN, Brancati F, Il’Yasov K, Huisman TA (2007) Diffusion tensor imaging in Joubert syndrome. AJNR Am J Neuroradiol 28(10):1929–1933CrossRef Poretti A, Boltshauser E, Loenneker T, Valente EN, Brancati F, Il’Yasov K, Huisman TA (2007) Diffusion tensor imaging in Joubert syndrome. AJNR Am J Neuroradiol 28(10):1929–1933CrossRef
23.
go back to reference Krishnamurthy S, Kapoor S, Sharma V, Prakash A (2008) Tectocerebellar dysraphia and occipital encephalocele: an unusual association with abdominal situs inversus and congenital heart disease. Indian J Pediatr 75(11):1178–1180CrossRef Krishnamurthy S, Kapoor S, Sharma V, Prakash A (2008) Tectocerebellar dysraphia and occipital encephalocele: an unusual association with abdominal situs inversus and congenital heart disease. Indian J Pediatr 75(11):1178–1180CrossRef
Metadata
Title
Tectocerebellar dysraphia and occipital encephalocele associated with trisomy X: case report and review of the literature
Authors
Lissa C. Goulart
Luiz A. Ferreira-Filho
Mariana M. da Silva
Israel S. B. Carneiro
Siderley S. Carneiro
Osvaldo Vilela-Filho
Publication date
01-10-2021
Publisher
Springer Berlin Heidelberg
Published in
Child's Nervous System / Issue 10/2021
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-020-04989-6

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