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[Angiographic findings of atrophic cerebral disorders in children]
Insights
Cerebral angiography in children reveals that slow cerebral blood flow is linked to arterial narrowing and altered venous drainage patterns, potentially contributing to cerebral atrophy. These findings offer insights into the vascular aspects of pediatric brain disorders.
Area of Science:
- Pediatric Neurology
- Neuroradiology
- Vascular Imaging
Background:
- Cerebral atrophy in children can result from various conditions including H-H-E syndrome, meningoencephalitis, head trauma, and infantile spasms.
- Understanding the vascular underpinnings of cerebral atrophy is crucial for diagnosis and management.
Purpose of the Study:
- To investigate angiographic findings in children diagnosed with cerebral atrophy.
- To correlate cerebral blood flow dynamics and venous drainage patterns with different types of cerebral atrophy.
Main Methods:
- Cerebral angiographies were performed on 20 pediatric patients (6 months to 16 years) with diagnosed cerebral atrophy.
- Analysis focused on circulation time, arterial caliber, and cortical and deep venous opacification.
- Patients were categorized by clinical and radiological diagnoses, including hemiatrophy, generalized atrophy, and focal atrophy.
Main Results:
- Slow cerebral blood flow was observed in 50% of cases, often associated with arterial narrowing.
- Hemiatrophy cases showed smaller middle cerebral arteries and slow circulation in the affected hemisphere.
- Altered venous drainage, with compensatory prominence of either cortical or deep veins, was noted, particularly in slow circulation cases, resembling patterns seen in Sturge-Weber syndrome.
Conclusions:
- Angiographic findings indicate a significant association between slow cerebral blood flow, specific arterial and venous changes, and cerebral atrophy in children.
- The exact causes of these vascular alterations remain unknown but are implicated in the pathogenesis of cerebral atrophic disorders.
- Venous drainage patterns may exhibit compensatory mechanisms between cortical and deep veins in response to impaired cerebral circulation.
Abstract:
Angiographic findings of the cerebral atrophy in children are discussed. Cerebral angiographies were performed on 20 patients, ranging from 6 months to 16 years of age. Their clinical diagnoses were H-H-E syndrome (4 cases), sequelae of meningoencephalitis (2), sequelae of head trauma (3), infantile spasms (2) and others (9). Final radiological diagnoses of these cases were hemiatrophy (14 cases), generalized atrophy (2) and focal atrophy (4). Circulation time, caliber of arteries, degree of opacification in cortical and deep veins and early filling of deep veins were investigated on angiogram. Slow circulation of cerebral blood flow was shown in 10 cases and normal circulation in 10 cases. Arterial narrowing was observed more frequently in slow circulation group. In cases with hemiatrophy, small caliber of the middle cerebral arteries and slow circulation on the atrophic hemisphere were demonstrated, but no abnormality on the normal side. Deep veins were prominently opacified in cases which showed poor cortical veins, the other way cortical veins were prominent in cases which showed poor visualization of deep veins. Cortical veins and deep veins may compensate each other in cerebral venous drainage. In most cases of slow circulation, dominant opacification of deep veins were visualized and these veins already appeared in arterial phase, but cortical veins had a tendency of poor opacification. These venous drainage patterns are similar to those of Sturge-Weber syndrome. Causes of these vascular changes are unknown. But they may play an important role in cerebral atrophic disorders.(ABSTRACT TRUNCATED AT 250 WORDS)