Journal of Pediatric Neuroradiology - Volume 1, issue 4

Authors: Poretti, Andrea | Chalian, Majid | Meoded, Avner | Huisman, Thierry A.G.M.

Article Type: Review Article

Abstract: Distinguishing “real” neoplastic tumors from “tumor-like” lesions of the central nervous system is important to treat children properly, to predict outcome and prognosis, and to avoid unnecessary medical treatment or surgical interventions. Neuroimaging plays a key role in the correct differentiation between both entities. Pediatric radiologists should be aware of all non-neoplastic lesions that may mimic tumors. High-end anatomic and advanced magnetic resonance imaging as well as the correlation with history and clinical findings facilitate differentiation between both entities. The aim of this pictorial review is to review the neuroimaging manifestations of the most common “tumor-like” lesions affecting the pediatric …brain. Show more

Keywords: Tumor-like lesions, central nervous system, pediatrics, MRI

DOI: 10.3233/PNR-2012-033

Citation: Journal of Pediatric Neuroradiology, vol. 1, no. 4, pp. 261-267, 2012

Authors: Dill, Patricia | Bosemani, Thangamadhan | Bhakta, Mehul | Poretti, Andrea | Huisman, Thierry A.G.M.

Article Type: Research Article

Abstract: The purpose of this study is to evaluate the influence of magnetic resonance imaging (MRI) findings in fetuses with sonographically evident ventriculomegaly with regard to the provision of additional information: as an isolated finding, as an acquired pathology, or as a part of a syndrome/malformation complex. Thirty-eight women with fetal ventriculomegaly suspected by prenatal ultrasonography (US) were referred to our institution from October 2002 to January 2007 for fetal MRI. In 11 cases, US and MRI findings were comparable. In seven cases, MRI specified the diagnosis without changing management or counseling, while in three cases, additional findings led to a …change in management and/or counseling. In 12 cases, the diagnosis was made based on MRI findings; in five cases, neither US nor MRI detected the underlying pathology for ventriculomegaly prenatally, with the final diagnosis being made postnatally. Fetal MRI has proven to have a significant impact in the majority of cases (33/38) by confirming, completing, or correcting US diagnoses, enabling adequate management and counseling. On the basis of our observations, we discuss selected causes of ventriculomegaly via a neuropediatric approach with a focus on prognosis and outcome. Show more

Keywords: Fetal MRI, fetal ultrasound, ventriculomegaly, brain malformation

DOI: 10.3233/PNR-2012-034

Citation: Journal of Pediatric Neuroradiology, vol. 1, no. 4, pp. 269-281, 2012

Authors: Anık, Ihsan | Korkmaz, Mehmet | Anık, Yonca | Koç, Kenan | Yıldız, Demir Kürşat | Çorapcıoğlu, Funda | Ceylan, Savaş | Bulut, Safiye Sanem

Article Type: Research Article

Abstract: A case of surgically resected solitary parenchymal brain tumor in a 13-year-old girl, who was treated 18 months ago with chemotherapy and radiotherapy for cervical vertebral Ewing sarcoma is presented. The intracranial primitive neuroectodermal tumor was detected after admission for severe headache. No other metastasis or recurrences were encountered following 14 months after brain surgery. The authors discuss whether this parenchymal brain tumor was a metastasis or a second primary Ewing sarcoma/primitive neuroectodermal tumor.

Keywords: Ewing sarcoma, primitive neuroectodermal tumor, pediatric tumors, metastasis

DOI: 10.3233/PNR-2012-035

Citation: Journal of Pediatric Neuroradiology, vol. 1, no. 4, pp. 283-286, 2012

Authors: Mansour, Asem H. | Haikal, Ali H. | Omari, Hamzi Z. | Nofal, Abdallah J. | Swaidan, Maisa Y.

Article Type: Research Article

Abstract: We report three female pediatric patients with plexiform neurofibromas affecting the genitourinary system. We describe the characteristic imaging findings of genitourinary plexiform neurofibromas. For the first time we describe a distinctive radiologic sign of vaginal involvement which we called “Mercedes-Benz sign” due to the resemblance in appearance at the axial plane.

Keywords: Plexiform neurofibroma, genitourinary, Mercedes-Benz sign, pediatrics

DOI: 10.3233/PNR-2012-036

Citation: Journal of Pediatric Neuroradiology, vol. 1, no. 4, pp. 287-292, 2012

Authors: Skoumi, Mohammed | Lmejjati, Mohammed | Aniba, Khalid | Laghmari, Mehdi | Ghannane, Houssine | Benali, Said Ait

Article Type: Research Article

Abstract: Spinal infection is rare in children, especially in young infants. The most common etiology is bacteria; Staphylococcus aureus in particular. Mycobacterium tuberculosis is another rare cause. We report an unusual dorsal spinal abscess with spinal cord compression in a 20-month-old infant. The presenting symptoms were weakness in the inferior limbs, gait disturbance and dorsal deformation for 3 mo. Neurological examination showed a spastic paraparesis and hypoesthesia. Magnetic resonance imaging showed a destruction of fourth vertebral body with anterior extension to posterior mediastinum and spinal cord compression. The patient underwent an emergency neurosurgical decompression by minimal posterior approach laminectomy …and removal of tuberculosis granuloma. Histological examination confirms M. tuberculosis . After 9 mo of antituberculosis treatment, the girl could walk without assistance. We conclude that spinal tuberculosis should be considered in cases of children and infants with cord-compression. Early diagnosis and prompt treatment are critical for maximizing a functional recovery. Show more

Keywords: Infant, tuberculosis, cord compression, MRI, surgery

DOI: 10.3233/PNR-2012-037

Citation: Journal of Pediatric Neuroradiology, vol. 1, no. 4, pp. 293-297, 2012

Authors: Oommen, Samuel P. | Jasper, Anitha | Sridhar, Gibikote | Govindarajan, Jeyanthi

Article Type: Research Article

Abstract: Middle interhemispheric holoprosencephaly (MIH) or syntelencephaly is a variant of holoprosencephaly in which the posterior frontal and parietal lobes are fused, while the frontal poles and the occipital lobes are separated by the interhemispheric fissure. We describe a two and half year old girl who presented with spastic diplegia, in whom the magnetic resonance imaging revealed MIH. Her ambulation was limited by the spasticity of her limbs but her language, social and adaptive skills were much ahead of her motor abilities. Etiopathogenesis of MIH and its differences from the ‘classic’ forms of holoprosencephaly are also discussed.

Keywords: Syntelencephaly, middle interhemispheric variant, holoprosencephaly

DOI: 10.3233/PNR-2012-038

Citation: Journal of Pediatric Neuroradiology, vol. 1, no. 4, pp. 299-303, 2012

Authors: Leach, James L. | Howard, Travis | Abruzzo, Todd | Jones, Blaise V. | Crone, Kerry

Article Type: Research Article

Abstract: Developmental venous anomalies (DVAs) are the most frequently encountered brain parenchymal vascular malformation. They are thought to arise during intrauterine development; however, the pathogenesis of these lesions remains unknown. A unique case documenting the postnatal evolution of a DVA in the left cerebellum of a young child is presented and the current literature on the pathogenesis and imaging characteristics of these anomalies is reviewed. Our case strongly suggests that the processes contributing to DVA maturation can extend into the postnatal period.

Keywords: Developmental venous anomaly, venous angioma

DOI: 10.3233/PNR-2012-039

Citation: Journal of Pediatric Neuroradiology, vol. 1, no. 4, pp. 305-311, 2012

Authors: Kalina, Peter | Rykken, Jeffrey

Article Type: Research Article

Abstract: We report the case of a 13-year-old boy who underwent a head computed tomography for seizures revealing an incidental very large intrasphenoidal Rathke cleft cyst (RCC). The initial pre-operative differential diagnosis included meningocele and mucocele. It is important to consider a benign entity such as RCC to avoid potential unnecessary aggressive intervention. This is only the second reported case of an intrasphenoidal RCC and it is the first reported case of an intrasphenoidal RCC in the pediatric population.

Keywords: Rathke’s cleft cyst, pediatric, sella

DOI: 10.3233/PNR-2012-040

Citation: Journal of Pediatric Neuroradiology, vol. 1, no. 4, pp. 313-316, 2012

Authors: Hekimoglu, Koray | Yıldırım Donmez, Fuldem | Yılmaz, Burcin | Sarıalioglu, Faik

Article Type: Research Article

Abstract: Mulibrey (muscle, liver, brain, eye) nanism (MUL) is an autosomal recessive disorder caused by mutations in the TRIM37 gene encoding a protein of unknown function. MUL is characterized by progressive growth failure of prenatal onset, triangular face with hydrocephaloid skull, general thinness and muscular hypotonicity, peculiar voice, venous congestion caused by pericardial constriction, and pigment dispersion and yellowish dots in ocular fundi. Many studies in MUL patients showed that MUL is associated with frequent malignant tumors, benign adenomas and vascular lesions. Generally, MUL patients are considered neurologically normal. Up to today, several arachnoidal cysts have been demonstrated in MUL patients. …A nodular lesion of the plexus choroideus has been detected only in one MUL patient. Thus, choroid plexus papilloma has never been demonstrated in MUL patients. Our patient is an unusual example of MUL with giant choroid plexus papilloma and the first case in literature. Show more

Keywords: Mulibrey nanism, choroid plexus papilloma, brain tumor

DOI: 10.3233/PNR-2012-041

Citation: Journal of Pediatric Neuroradiology, vol. 1, no. 4, pp. 317-319, 2012

Article Type: Other

Citation: Journal of Pediatric Neuroradiology, vol. 1, no. 4, pp. 321-323, 2012