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The postmigrational development of polymicrogyria documented by magnetic resonance imaging from 31 weeks'
T E Inder1, P S Huppi, G P Zientara
1Department of Neurology, Children's Hospital and Harvard Medical School, Boston, MA 02115, USA.
Insights
This study documents the developmental changes of bilateral perisylvian polymicrogyria in a premature infant using advanced magnetic resonance imaging (MRI) techniques. The findings offer new insights into the evolution of this brain malformation in early life.
Area of Science:
- Neuroimaging
- Developmental Neuroscience
- Pediatric Neurology
Background:
- Polymicrogyria is a cortical malformation characterized by an excessive number of small, redundant gyri.
- Its etiology is often complex, involving genetic and environmental factors.
- Understanding the developmental trajectory of polymicrogyria is crucial for predicting neurodevelopmental outcomes.
Observation:
- Serial magnetic resonance imaging (MRI) in a 27-week premature infant revealed the postnatal evolution of bilateral perisylvian polymicrogyria.
- Ultrafine 1.5-mm coronal slices on 3D spoiled gradient-recalled and T2-weighted MRI sequences effectively detected the polymicrogyria.
- The imaging documented the postmigrational changes of the cortical malformation from 31 weeks postconceptional age to 6 months corrected age.
Findings:
- This is the first in vivo documentation of the postmigrational evolution of polymicrogyria.
- The observed polymicrogyria showed clear developmental changes over the first six months of life.
- Simultaneous periventricular leukomalacia suggests a potential ischemic encephaloclastic mechanism contributing to the polymicrogyria.
Implications:
- These findings advance our understanding of polymicrogyria's in vivo developmental course.
- Advanced MRI techniques are vital for early detection and characterization of cortical malformations.
- The potential link to ischemic events highlights the importance of monitoring premature infants for brain injury and associated malformations.
Abstract:
We report the case of a 27-week premature infant in whom magnetic resonance imaging (MRI) at 4 postnatal weeks (postconceptional age, 31 weeks), term, and 6 months of age documented the postnatal postmigrational evolution of bilateral perisylvian polymicrogyria. The polymicrogyria was readily detected by ultrafine 1.5-mm coronal slices on three-dimensional, Fourier-transformed, spoiled gradient-recalled and T2-weighted MRI sequences. These MRI sequences provide the first in vivo documentation of the postmigrational evolution of polymicrogyria. The likelihood that the polymicrogyria was related to an ischemic encephaloclastic mechanism is supported by the simultaneous occurrence of periventricular leukomalacia.