MR Imaging of Malformations of Cortical Development
Dalia Mohamed Medhat El-Mossly;
Abstract
MCDs are significant causes of developmental disability and epileptic seizures are an associated symptom in over three quarters of patients. The seizures may arise at any age, but epilepsy will usually commence in childhood and is often resistant to anticonvulsant medications.
Structural imaging findings of brain, especially magnetic resonance imaging (MRI) findings are the most important non-invasive technique for its diagnosis, which has greatly improved with the progress in the neuroimaging techniques, thus smaller lesions have been described. Since underlying MCDs could be present in many cases of intractable childhood epilepsy. therefore, MCDs should be excluded in every case of developmental delay, epilepsy or congenital neurological deficits by neuroimaging techniques.
72% of the children were presented with epilepsy which was the chief clinical feature, while 19.5% presented with focal epilepsy. The second most common clinical presentation was global developmental delay (21%).
There was an association between focal cortical dysplasia and focal epilepsy and also between polymicrogyria and global developmental delay.
The most common type of MCD was polymicrogyria (25%) followed by Tuberous sclerosis (21%) which was the second most common type, among which 27% cases were complicated with giant cell astrocytoma, then followed by heterotopia (15%), focal cortical dysplasia (15%).
Multiple abnormalities were noted in 55.5 % of the cases; the most common associated neuroimaging findings were variable degrees of ventricular dilatation exvacu and white matter abnormal signal or delayed myelination, thus denoting that the malformation not only a cortical defect, but also part of brain aberration that could involve white matter as well.
MCD cannot occur sporadically, but can occur in association, or as a part of other syndromes. The most common associated combinations were between hemimegalencephaly and polymicrogyria, lissencephaly and microcephaly as well as schizencephaly and polymicrogyria.
Structural imaging findings of brain, especially magnetic resonance imaging (MRI) findings are the most important non-invasive technique for its diagnosis, which has greatly improved with the progress in the neuroimaging techniques, thus smaller lesions have been described. Since underlying MCDs could be present in many cases of intractable childhood epilepsy. therefore, MCDs should be excluded in every case of developmental delay, epilepsy or congenital neurological deficits by neuroimaging techniques.
72% of the children were presented with epilepsy which was the chief clinical feature, while 19.5% presented with focal epilepsy. The second most common clinical presentation was global developmental delay (21%).
There was an association between focal cortical dysplasia and focal epilepsy and also between polymicrogyria and global developmental delay.
The most common type of MCD was polymicrogyria (25%) followed by Tuberous sclerosis (21%) which was the second most common type, among which 27% cases were complicated with giant cell astrocytoma, then followed by heterotopia (15%), focal cortical dysplasia (15%).
Multiple abnormalities were noted in 55.5 % of the cases; the most common associated neuroimaging findings were variable degrees of ventricular dilatation exvacu and white matter abnormal signal or delayed myelination, thus denoting that the malformation not only a cortical defect, but also part of brain aberration that could involve white matter as well.
MCD cannot occur sporadically, but can occur in association, or as a part of other syndromes. The most common associated combinations were between hemimegalencephaly and polymicrogyria, lissencephaly and microcephaly as well as schizencephaly and polymicrogyria.
Other data
| Title | MR Imaging of Malformations of Cortical Development | Other Titles | الرنين المغناطيسى فى حالات التشوهات الخلقية فى القشرة المخية | Authors | Dalia Mohamed Medhat El-Mossly | Issue Date | 2017 |
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