Kawamura Tadao, Nishio Shunji, Morioka Takato, Fukui Kimiko
Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Neurol Res. 2002 Jul;24(5):463-7. doi: 10.1179/016164102101200348.
Dysgenesis of the corpus callosum can occur in association with spinal dysraphic lesions. Clinical and neuroimaging features were reviewed in 23 patients (12 male, 11 female; mean age 11.3 years) with caudal spinal dysraphism (myeloschisis in eight, meningomyelocele in 10, and lumbosacral lipoma in five) to characterize types and degrees of callosal and other cerebral anomalies. T1- and T2-weighted magnetic resonance images were obtained, and the total midsagittal cross-sectional area of the corpus callosum was determined. The corpus callosum appeared normal in nine patients and was abnormal in 14. In five patients the corpus callosum was narrow, with all regions present; the cerebral hemispheres were hypoplastic. Two patients with dysgenesis of frontal, parietal, and occipital lobes had a small, partly agenetic corpus callosum. In the remaining seven patients the posterior third of the corpus callosum was absent or hypoplastic; six of them had ventriculomegaly that selectively affected the occipital horns (colpocephaly). All callosal anomalies were accompanied by hemispheric ones. This supports a disordered developmental relationship between the corpus callosum and the hemispheres as a cause. Spinal dysraphism can no longer be considered a single developmental abnormality, given the frequent association of other defects.
胼胝体发育不全可与脊柱发育异常性病变相关联。对23例(12例男性,11例女性;平均年龄11.3岁)患有尾部脊柱发育异常(8例脊髓纵裂、10例脊髓脊膜膨出、5例腰骶部脂肪瘤)的患者的临床和神经影像学特征进行了回顾,以明确胼胝体及其他脑部异常的类型和程度。获取了T1加权和T2加权磁共振图像,并测定了胼胝体的总矢状面截面积。9例患者的胼胝体外观正常,14例异常。5例患者的胼胝体狭窄,但各区域均存在;脑半球发育不全。2例额叶、顶叶和枕叶发育不全的患者有一个小的、部分发育不全的胼胝体。在其余7例患者中,胼胝体后三分之一缺如或发育不全;其中6例有脑室扩大,且选择性地累及枕角(脑室后角扩大)。所有胼胝体异常均伴有半球异常。这支持了胼胝体与脑半球之间发育关系紊乱是病因这一观点。鉴于其他缺陷的频繁关联,脊柱发育异常不能再被视为单一的发育异常。