Top

Published in:

01-07-2020 | Magnetic Resonance Imaging | Original Article

Brain abnormalities in myelomeningocele patients

Authors: Bárbara Albuquerque Morais, Davi Jorge Fontoura Solla, Vitor Nagai Yamaki, Suely Fazio Ferraciolli, Cesar Augusto P.F. Alves, Daniel Dante Cardeal, Hamilton Matushita, Manoel Jacobsen Teixeira

Published in: Child's Nervous System | Issue 7/2020

Abstract

Background

Myelomeningocele (MMC) is often related to hydrocephalus and Chiari malformation (CM) type 2; however, other brain abnormalities have been reported in this population. In order to better understand and quantify other forebrain abnormalities, we analyzed magnetic resonance imaging (MRI) of MMC patients treated in utero or postnatal.

Methods

Between January 2014 and March 2017, 59 MMC were treated in our hospital. Thirty-seven patients (32 postnatal and 5 intrautero repair) had brain MRI and were enrolled at the study. MRI was analyzed by two experienced neuroradiologists to identify the supra and infratentorial brain abnormalities.

Results

A wide range of brain abnormalities was consistently identified in MMC patients. As expected, the most common were hydrocephalus (94.5%) and CM type II (89.1%). Of note, we found high incidence of corpus callosum abnormalities (86.4%), mostly represented by dysplasia (46%).

Conclusions

The data are consistent with the concept that brain abnormalities related to MMC can be both infratentorial and supratentorial, cortical, and subcortical. More studies are needed to correlate these forebrain abnormalities to long-term functional outcome and their prognostic value for these patients.

Available only for authorised users

Alexiou GA, Zarifi MK, Georgoulis G et al (2011) Cerebral abnormalities in infants with myelomeningocele. Neurol Neurochir Pol 45:18–23. https://doi.org/10.1016/S0028-3843(14)60055-4 CrossRefPubMed

Bekiesinska-Figatowska M, Duczkowska A, Brągoszewska H et al (2014) Stenogyria - Not only in Chiari II malformation. J Neurol Sci 347:337–340. https://doi.org/10.1016/j.jns.2014.09.022 CrossRefPubMed

Copp AJ, DE Greene N (2014) Europe PMC Funders Group Neural tube defects – disorders of neurulation and related embryonic processes. Wiley Interdiscip Rev Dev Biol 2:213–227. https://doi.org/10.1002/wdev.71.Neural CrossRef

Crawley JT, Hasan K, Hannay HJ et al (2014) Structure, integrity, and function of the hypoplastic corpus callosum in spina bifida myelomeningocele. Brain Connect 4:608–618. https://doi.org/10.1089/brain.2014.0237 CrossRefPubMedPubMedCentral

Dias M, Partington M (2015) Congenital Brain and Spinal Cord Malformations and Their Associated Cutaneous Markers. Pediatrics 136:e1105–e1119. https://doi.org/10.1542/peds.2015-2854 CrossRefPubMed

Gilbert JN, Jones KL, Rorke LB et al (1986) Central Nervous System Anomalies Associated with Meningomyelocele, Hydrocephalus, and the Arnold-Chiari Malformation: Reappraisal of Theories Regarding the Pathogenesis of Posterior Neural Tube Closure Defects. Neurosurgery 18:559–564CrossRef

Glenn OA, Barkovich AJ (2006) Magnetic resonance imaging of the fetal brain and spine: an increasingly important tool in prenatal diagnosis, part 1. Am J Neuroradiol 27:1604PubMed

Hasan KM, Eluvathingal TJ, Kramer LA et al (2008) White matter microstructural abnormalities in children with spina bifida myelomeningocele and hydrocephalus: a diffusion tensor tractography study of the association pathways. J Magn Reson Imaging 27:700–709. https://doi.org/10.1002/jmri.21297 CrossRefPubMedPubMedCentral

Kawamura T, Marioka T, Nishio S et al (2001) Cerebral abnormalities in lumbosacral neural tube closure defect: MR imaging evaluation. Childs Nerv Syst 17:405–410. https://doi.org/10.1007/s003810000439 CrossRefPubMed

10.

McLone DG, Knepper PA (1989) The cause of Chiari II malformation: a unified theory. Pediatr Neurosci 15:1–12CrossRef

11.

Miller E, Widjaja E, Blaser S et al (2008) The old and the new: Supratentorial MR findings in Chiari II malformation. Childs Nerv Syst 24:563–575. https://doi.org/10.1007/s00381-007-0528-x CrossRefPubMed

12.

Glenn OA, Barkovich AJ (2006) Magnetic resonance imaging of the fetal brain and spine: An increasingly important tool in prenatal diagnosis: Part 2. Am J Neuroradiol 27:1604–1611PubMed

13.

O’Hayon BB, Drake JM, Ossip MG et al (1998) Frontal and occipital horn ratio: A linear estimate of ventricular size for multiple imaging modalities in pediatric hydrocephalus. Pediatr Neurosurg 29:245–249. https://doi.org/10.1159/000028730 CrossRefPubMed

14.

Rethmann C, Scheer I, Meuli M et al (2017) Evolution of posterior fossa and brain morphology after in utero repair of open neural tube defects assessed by MRI. Eur Radiol 27:4571–4580. https://doi.org/10.1007/s00330-017-4807-y CrossRefPubMed

15.

Treble A, Juranek J, Stuebing KK et al (2013) Functional significance of atypical cortical organization in spina bifida myelomeningocele: Relations of cortical thickness and gyrification with IQ and fine motor dexterity. Cereb Cortex 23:2357–2369. https://doi.org/10.1093/cercor/bhs226 CrossRefPubMed

16.

Tulipan N, Bruner JP, Hernanz-Schulman M et al (1999) Effect of intrauterine myelomeningocele repair on central nervous system structure and function. Pediatr Neurosurg 31:183–188. https://doi.org/10.1159/000028859 CrossRefPubMed

17.

Ware AL, Juranek WVJ et al (2014) Anatomical and diffusion MRI of deep gray matter in pediatric spina bifida. NeuroImage Clin 5:120–127. https://doi.org/10.1016/j.nicl.2014.05.012 CrossRefPubMedPubMedCentral

Title: Brain abnormalities in myelomeningocele patients
Authors: Bárbara Albuquerque Morais
Davi Jorge Fontoura Solla
Vitor Nagai Yamaki
Suely Fazio Ferraciolli
Cesar Augusto P.F. Alves
Daniel Dante Cardeal
Hamilton Matushita
Manoel Jacobsen Teixeira
Publication date: 01-07-2020
Publisher: Springer Berlin Heidelberg
Keywords: Magnetic Resonance Imaging
Magnetic Resonance Imaging
Cranial MRI
Hydrocephalus
Hydrocephalus
Hydrocephalus
Chiari Malformation
Chiari Malformation
Published in: Child's Nervous System / Issue 7/2020
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-019-04386-8

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Brain abnormalities in myelomeningocele patients

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 7/2020

Decreased natural killer cells in diffuse intrinsic pontine glioma patients

A reply to the letter to the editor by Jaskaran Singh Gosal with regard to the paper “Diffuse leptomeningeal glioneuronal tumour (DLGNT) with hydrocephalus as an initial symptom: a case-based update”

Ki67 as a prognostic factor of craniopharyngioma’s recurrence in paediatric population

Intraventricular microcystic meningioma in a child: a case report

Spinal epidural abscess in children: a case-based review

Cerebral neoplasm in L-2-hydroxyglutaric aciduria: two different presentations