Supratentorial Intracranial Anomalies in Myelomeningocele Patients
Larisa Andrada Ay1, Ibrahim Alatas, Bahattin Ozkul
1Mardin Kiziltepe State Hospital, Department of Neurosurgery, Mardin, Türkiye.
Insights
This study found common cerebral supratentorial anomalies, particularly corpus callosum issues, in pediatric myelomeningocele patients. Further research is needed to understand their impact on neurological development.
Area of Science:
- Neuroscience
- Pediatric Neurology
- Developmental Biology
Background:
- Myelomeningocele repair is a common neurosurgical procedure in pediatric patients.
- Associated central nervous system anomalies are frequently observed in myelomeningocele.
- Understanding supratentorial anomalies is crucial for comprehensive patient management.
Purpose of the Study:
- To investigate the prevalence and types of supratentorial anomalies in pediatric patients post-myelomeningocele repair.
- To enhance the morphological understanding of forebrain anomalies in this patient cohort.
Main Methods:
- Retrospective observational study of 426 pediatric patients undergoing myelomeningocele repair (2013-2020).
- Cranial MRI (T1- and T2-weighted sequences) analyzed for supratentorial anomalies.
- Data collected on corpus callosum configuration, gray matter heterotopia, septum pellucidum, interhemispheric fissure, white matter maturation, and polymicrogyria.
Main Results:
- Corpus callosum anomalies were most frequent: complete agenesis (2.1%), partial agenesis (34.7%), and hypoplasia (0.7%).
- Gray matter heterotopia occurred in 25.8% of patients.
- Other anomalies included absent septum pellucidum (0.47%), widened interhemispheric fissure (2.34%), abnormal white matter maturation (2.58%), and polymicrogyria (22.53%).
Conclusions:
- Cerebral supratentorial anomalies, beyond hydrocephalus and Chiari malformation, are common in myelomeningocele patients.
- The link between these anomalies and cognitive function requires further investigation.
- Additional studies and postnatal follow-up are essential to determine the clinical significance of these structural brain changes.
Aim:
To assess associated cerebral supratentorial anomalies in patients who underwent myelomeningocele repair in hopes of developing a better morphological apprehension of the forebrain?s anomalies in this category of patients.
Material And Methods:
This retrospective observational study assessed 426 pediatric patients who underwent myelomeningocele repair between January 2013 and December 2020. Cranial MRIs with T1- and T2-weighted sequences were obtained as part of the postoperative assessment to determine the presence of associated supratentorial anomalies in pediatric patients following myelomeningocele repair.
Results:
The most common supratentorial anomalies identified in patients who underwent myelomeningocele repair are associated with the configuration of the corpus callosum (CC). Moreover, the complete agenesis of the CC was noticed in 9 (2.1%) subjects, whereas partial agenesis was identified in 148 (34.7%) subjects. Hypoplasia of the CC was observed in three (0.7%) patients. Gray matter heterotopia were the second most commonly observed supratentorial anomalies in 110 (25.8%) patients. Furthermore, the absence of the septum pellucidum was observed in two (0.47%) of the total patients. The widening of the interhemispheric fissure and abnormal maturation of the white matter were observed in 10 (2.34%) patients and 11 (2.58%) patients, respectively. Polymicrogyria, a consequence of abnormal cortical organization, was identified in 22.53% of the patients (96 patients) included in our series.
Conclusion:
This study confirms that, except for hydrocephalus and Chiari malformation, other associated cerebral supratentorial anomalies may be observed in patients with myelomeningocele. However, only limited research has confirmed the interconnection between the cerebral supratentorial anomalies and cognitive function. Therefore, this study emphasizes the necessity for further supplementary studies, in conjunction with accurate postnatal followups, in order to assess the real significance and repercussions of these anomalies on neurological development and also to establish how these structural changes in brain anatomy translate clinically.
