Gökçe Erkan, Beyhan Murat, Sade Recep
Gaziosmanpaşa University Medicine School, Merkez, Tokat, Turkey.
Department of Radiology, Tokat State Hospital, Tokat, Turkey.
Acta Neurol Belg. 2017 Dec;117(4):885-893. doi: 10.1007/s13760-017-0778-7. Epub 2017 Apr 3.
Radiological findings of Dyke-Davidoff-Masson syndrome (DDMS) in patients with different etiologies are presented in our study. The study included 12 patients (seven females, five males) for whom radiological examinations were requested due to reasons such as epilepsy, mental retardation, and/or hemiplegia. CT was performed in 12, MRI in 6, MRA in 1, and DSA in 1 patient. Following imaging findings were evaluated: cerebral and cerebellar involvement (laterality, encephalomalacia), affected territories, ventricular enlargement, sulcal enlargement, calvarial thickening, and paranasal sinus enlargement hyperaeration. Age range of the patients was 5-62 (mean 34.1 ± 21.7). Left hemicrania was affected in eight patients, right hemicrania in four. Ipsilateral calvarial thickening and lateral ventricular dilatation were observed in all patients. 11 patients had ipsilateral frontal sinus hyperaeration, sulcal enlargement and encephalomalacia. Wallerian degeneration of the mesencephalon and middle fossa hypoplasia was seen in ten patients, mastoid hyperaeration, third ventricular enlargement and thalamic involvement in nine, and corpus callosum, basal ganglion injury, and sphenoid sinus hyperaeration in eight. MCA, ACA, and PCA territories were involved in six patients. Only MCA territory involvement was seen in four patients. Cerebellar atrophy was contralateral in two patients. Symmetric bilateral atrophy was observed in one patient. DDMS can be encountered with different radiological findings based on cerebral damage formation process and the extent of damage. Patients may have different levels of cerebral hemiatrophy, ipsilateral carvarial thickening, and lateral ventricular dilatation.
我们的研究展示了不同病因的戴克-戴维多夫-马森综合征(DDMS)患者的放射学表现。该研究纳入了12例患者(7例女性,5例男性),这些患者因癫痫、智力发育迟缓及/或偏瘫等原因接受了放射学检查。12例患者进行了CT检查,6例进行了MRI检查,1例进行了MRA检查,1例进行了DSA检查。对以下影像学表现进行了评估:大脑和小脑受累情况(左右侧、脑软化)、受累区域、脑室扩大、脑沟增宽、颅骨增厚以及鼻窦扩大及过度充气。患者年龄范围为5 - 62岁(平均34.1 ± 21.7)。8例患者左侧颅骨受累,4例右侧颅骨受累。所有患者均观察到同侧颅骨增厚和侧脑室扩张。11例患者存在同侧额窦过度充气、脑沟增宽和脑软化。10例患者可见中脑华勒氏变性和中颅窝发育不全,9例有乳突过度充气、第三脑室扩大和丘脑受累,8例有胼胝体、基底节损伤和蝶窦过度充气。6例患者大脑中动脉(MCA)、大脑前动脉(ACA)和大脑后动脉(PCA)供血区域受累。4例患者仅见MCA供血区域受累。2例患者小脑萎缩为对侧性。1例患者观察到对称性双侧萎缩。基于脑损伤形成过程和损伤程度,DDMS可出现不同的放射学表现。患者可能有不同程度的大脑半球萎缩、同侧颅骨增厚和侧脑室扩张。