Gálvez V Camila, Huete Isidro, Hernández Marta
División de Pediatría, Unidad de Neurología Pediátrica, Chile.
Departamento de Radiología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Chile.
Rev Chil Pediatr. 2018 Feb;89(1):92-97. doi: 10.4067/S0370-41062018000100092.
Hydrocephalus is defined as complex conditions influenced by genetic and environmental factors. Excluding hydrocephalus acquired from infection or brain tumors, congenital hydrocephalus with a genetic cause may occur isolated (hydrocephalus isolated, pure or non-syndromatic) or as a component of a genetic syndrome (syndromic hydrocephalus).
To present a syndromic congenital hydrocephalus with a known diagnosis, in order to be considered in the study of this pathology and to perform a review of hydrocephaly with a genetic cause.
Preschool with a prenatal diagnosis of hydrocephalus and rhombencephalosynapsis, karyotype and study of TORCH was normal. At the moment of birth, the prenatal diagnoses were confirmed and a malformation of cerebral cortical development was excluded. During the first week of life, perito neal ventricle shunt was performed. A reevaluation at age 4, the absence of corneal reflexes bilate ral parietal and congenital focal alopecia associated with rhombencephalosynapsis, meet definitive criteria for cerebello-trigeminal-dermal displasia or Gómez-López-Hernández syndrome (GLHS).
GLHS is an uncommon neurocutaneous syndrome, possibly a sporadic condition that is underdiagnosed. Due to the new imaging and genetic technologies pre and post-natal, today it is possible to achieve a better and more accurate diagnosis of hydrocephalus with a genetic origin, in which the high suspicion of teams of clinical specialists is essential. Without accurate diagnosis, we can not access to a long-term prognosis, prevention of aggregate morbidity or an adequate genetic counseling, which are required in today's pediatrics.
脑积水被定义为受遗传和环境因素影响的复杂病症。排除由感染或脑肿瘤引起的脑积水,具有遗传病因的先天性脑积水可能单独出现(孤立性脑积水、单纯性或非综合征性脑积水),也可能作为遗传综合征的一部分出现(综合征性脑积水)。
介绍一例已确诊的综合征性先天性脑积水病例,以便在对该病症的研究中予以考虑,并对具有遗传病因的脑积水进行综述。
一名学龄前儿童,产前诊断为脑积水和菱形脑联合,核型及TORCH检查正常。出生时,产前诊断得到证实,排除了大脑皮质发育畸形。在出生后的第一周,进行了腹膜脑室分流术。4岁时复查,双侧顶叶角膜反射缺失以及与菱形脑联合相关的先天性局限性脱发,符合小脑 - 三叉 - 皮肤发育异常或戈麦斯 - 洛佩斯 - 埃尔南德斯综合征(GLHS)的明确标准。
GLHS是一种罕见的神经皮肤综合征,可能是一种诊断不足的散发性病症。由于产前和产后新的影像学和基因技术,如今有可能对具有遗传起源的脑积水做出更好、更准确的诊断,其中临床专家团队的高度怀疑至关重要。没有准确的诊断,我们就无法获得长期预后、预防合并症或进行充分的遗传咨询,而这些在当今儿科中是必需的。