Brain abnormalities in myelomeningocele patients

Bárbara Albuquerque Morais1, Davi Jorge Fontoura Solla2, Vitor Nagai Yamaki2

  • 1Department of Neurosurgery, Hospital das Clínicas, School of Medicine, University of São Paulo, Street Eneas de Carvalho, 155, Pinheiros-, São Paulo, São Paulo, Brazil. babyamorais@gmail.com.

Abstract

Insights

Myelomeningocele (MMC) is linked to various brain abnormalities beyond hydrocephalus and Chiari malformation. This study quantifies these forebrain issues in MMC patients, revealing high rates of corpus callosum abnormalities.

Area of Science:

  • Neuroscience
  • Developmental Biology
  • Radiology

Background:

  • Myelomeningocele (MMC) is frequently associated with hydrocephalus and Chiari malformation type II.
  • However, a broader spectrum of central nervous system abnormalities exists in MMC patients.
  • Understanding these additional brain anomalies is crucial for comprehensive patient care.

Purpose of the Study:

  • To investigate and quantify the prevalence of forebrain abnormalities in patients with myelomeningocele (MMC).
  • To analyze magnetic resonance imaging (MRI) data from both in utero and postnatal MMC repair cohorts.
  • To characterize the range and incidence of supra- and infratentorial brain abnormalities in MMC.

Main Methods:

  • Retrospective analysis of brain MRI scans from 37 patients with myelomeningocele (MMC) treated between January 2014 and March 2017.
  • Inclusion criteria comprised patients undergoing either in utero or postnatal MMC repair.
  • Two experienced neuroradiologists independently reviewed MRI scans to identify and classify brain abnormalities.

Main Results:

  • Hydrocephalus (94.5%) and Chiari malformation type II (89.1%) were the most common findings, as expected.
  • A significant incidence of corpus callosum abnormalities was observed in 86.4% of patients, predominantly corpus callosum dysplasia (46%).
  • The study identified a wide range of both supratentorial and infratentorial brain abnormalities in the MMC cohort.

Conclusions:

  • Brain abnormalities in MMC encompass both infratentorial and supratentorial structures, affecting cortical and subcortical regions.
  • These findings underscore the complex neurodevelopmental impact of MMC.
  • Further research is necessary to correlate these forebrain abnormalities with long-term functional outcomes and prognostic value.

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