Brain abnormalities in male children and adolescents with hemophilia: detection with MR imaging. The Hemophilia Growth and Development Study Group.
Cranial magnetic resonance (MR) imaging was performed in 124 male patients (aged 7-19 years), from 14 institutions, in whom a diagnosis of moderate to severe hemophilia was made. Blood tests in all subjects were negative for human immunodeficiency virus. Findings in MR studies were abnormal in 25 (20.2%) subjects. Six lesions in five subjects were classified as congenital. The most commonly identified congenital lesion was a posterior fossa collection of cerebrospinal fluid (five cases). Twenty-two subjects had acquired lesions that were probably related to the hemophilia or its treatment. The most commonly acquired lesions were single- or multifocal areas of high signal intensity within the white matter on T2-weighted images noted in 14 (11.3%) subjects. Two subjects had large focal areas of brain atrophy, and six had some degree of diffuse cerebral cortical atrophy. Three subjects (2.4%) had hemorrhagic lesions. To the authors' knowledge, the unexpected finding of small, focal, nonhemorrhagic white matter lesions has not previously been reported.
Wilson
D A
DA
Magnetic Resonance Center of Oklahoma, Oklahoma Medical Center, Oklahoma City 73104.
Nelson
M D
MD
Fenstermacher
M J
MJ
Bohan
T P
TP
Hopper
K D
KD
Tilton
A
A
Mitchell
W G
WG
Contant
C F
CF
Maeder
M A
MA
Donfield
S M
SM
D000293:Adolescent; D000328:Adult; D001284:Atrophy; D001921:Brain / Q000473:pathology*; D001927:Brain Diseases / Q000175:diagnosis*; D002543:Cerebral Hemorrhage / Q000473:pathology; D002648:Child; D006679:HIV Seropositivity; D006467:Hemophilia A / Q000145:classification / Q000473:pathology*; D002836:Hemophilia B / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009460:Neurologic Examination; D015995:Prevalence; D012640:Seizures / Q000473:pathology; D014842:von Willebrand Diseases / Q000473:pathology