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Prenatal Brainstem Disruptions: Small Lesions-Big Problems


Boltshauser, Eugen; Bauder, Florian; Giarrana, Miriam; Hackenberg, Anette; Lebon, Sébastien; Roulet-Perez, Eliane; Schmid, Regula; Schmitt-Mechelke, Thomas; Poretti, Andrea (2017). Prenatal Brainstem Disruptions: Small Lesions-Big Problems. Neuropediatrics, 48(5):350-355.

Abstract

Prenatal disruptive injuries within one or both cerebellar hemispheres, which are mostly caused by hemorrhages, are well known. Primary disruptive lesions of the brainstem, however, are exceptional. Here we report on clinical and neuroimaging findings, as well as outcome of four male infants with prenatal brainstem disruptions that have been seen between 2005 and 2015. Two infants with extensive brainstem defects (from the midbrain to the medulla) had respiratory insufficiency and died at the age of 12 weeks and 22 months, respectively. Two patients had smaller, unilateral/asymmetrical lesions in the pontomesencephalic and medullary regions, respectively, and presented with permanent multiple cranial nerve deficits and long-tract signs. Recognition of prenatal brainstem disruptions and distinction from malformations are essential for the management and the estimation of a recurrence risk.

Abstract

Prenatal disruptive injuries within one or both cerebellar hemispheres, which are mostly caused by hemorrhages, are well known. Primary disruptive lesions of the brainstem, however, are exceptional. Here we report on clinical and neuroimaging findings, as well as outcome of four male infants with prenatal brainstem disruptions that have been seen between 2005 and 2015. Two infants with extensive brainstem defects (from the midbrain to the medulla) had respiratory insufficiency and died at the age of 12 weeks and 22 months, respectively. Two patients had smaller, unilateral/asymmetrical lesions in the pontomesencephalic and medullary regions, respectively, and presented with permanent multiple cranial nerve deficits and long-tract signs. Recognition of prenatal brainstem disruptions and distinction from malformations are essential for the management and the estimation of a recurrence risk.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Children's Hospital Zurich > Medical Clinic
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:October 2017
Deposited On:30 Jan 2018 11:06
Last Modified:19 Feb 2018 10:53
Publisher:Georg Thieme Verlag
ISSN:0174-304X
OA Status:Closed
Publisher DOI:https://doi.org/10.1055/s-0037-1603516
PubMed ID:28571098

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