Magnetic resonance imaging findings in infantile spasms: etiologic and pathophysiologic aspects.
An etiologic evaluation of 86 patients with infantile spasms is presented and the place of cranial magnetic resonance imaging (MRI) findings within this spectrum is discussed. A total of 103 cranial MRIs, performed between 4 and 72 months of age, were analyzed and classified according to the etiologic and pathophysiologic aspects. Ninety-one percent of cases were diagnosed as symptomatic infantile spasms, and hypoxic-ischemic encephalopathy was the primary cause (30%). The most common involvement was thinning of the corpus callosum in 43 patients (50%), followed by dilation of cerebral ventricles in 32 (36%), delayed myelination in 23 (26.7%), lesions of diencephalic deep gray matter in 17 (19.7%), and enlargement of the subarachnoid space in 12 (14%). Thin corpus callosum and diffuse atrophy were changes mainly associated with hypoxic-ischemic encephalopathy, whereas delayed myelination seemed to be independent from a specific etiology. The results showed that cranial MRI may provide considerable information regarding not only the etiology but also the pathophysiology of infantile spasms.
Saltik
Sema
S
Department of Neurology, Division of Child Neurology, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey. saltik@ixir.com
Kocer
Naci
N
Dervent
Aysin
A
D001921:Brain / Q000473:pathology* / Q000503:physiopathology*; D001927:Brain Diseases / Q000150:complications* / Q000175:diagnosis* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D030342:Genetic Diseases, Inborn / Q000150:complications* / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008659:Metabolic Diseases / Q000150:complications* / Q000175:diagnosis* / Q000503:physiopathology; D012307:Risk Factors; D012720:Severity of Illness Index; D013036:Spasms, Infantile / Q000175:diagnosis* / Q000209:etiology* / Q000503:physiopathology; D014057:Tomography, X-Ray Computed