Morais Bárbara Albuquerque, Solla Davi Jorge Fontoura, Yamaki Vitor Nagai, Ferraciolli Suely Fazio, Alves Cesar Augusto P F, Cardeal Daniel Dante, Matushita Hamilton, Teixeira Manoel Jacobsen
Department of Neurosurgery, Hospital das Clínicas, School of Medicine, University of São Paulo, Street Eneas de Carvalho, 155, Pinheiros-, São Paulo, São Paulo, Brazil.
Department of Radiology, Hospital das Clínicas, School of Medicine, University of São Paulo, Street Eneas de Carvalho, 155, Pinheiros-, São Paulo, São Paulo, Brazil.
Childs Nerv Syst. 2020 Jul;36(7):1507-1513. doi: 10.1007/s00381-019-04386-8. Epub 2019 Oct 29.
Myelomeningocele (MMC) is often related to hydrocephalus and Chiari malformation (CM) type 2; however, other brain abnormalities have been reported in this population. In order to better understand and quantify other forebrain abnormalities, we analyzed magnetic resonance imaging (MRI) of MMC patients treated in utero or postnatal.
Between January 2014 and March 2017, 59 MMC were treated in our hospital. Thirty-seven patients (32 postnatal and 5 intrautero repair) had brain MRI and were enrolled at the study. MRI was analyzed by two experienced neuroradiologists to identify the supra and infratentorial brain abnormalities.
A wide range of brain abnormalities was consistently identified in MMC patients. As expected, the most common were hydrocephalus (94.5%) and CM type II (89.1%). Of note, we found high incidence of corpus callosum abnormalities (86.4%), mostly represented by dysplasia (46%).
The data are consistent with the concept that brain abnormalities related to MMC can be both infratentorial and supratentorial, cortical, and subcortical. More studies are needed to correlate these forebrain abnormalities to long-term functional outcome and their prognostic value for these patients.
脊髓脊膜膨出（MMC）常与脑积水和2型Chiari畸形（CM）相关；然而，该人群中也有其他脑异常的报道。为了更好地理解和量化其他前脑异常，我们分析了在子宫内或出生后接受治疗的MMC患者的磁共振成像（MRI）。
2014年1月至2017年3月期间，我院治疗了59例MMC患者。37例患者（32例出生后治疗和5例子宫内修复）进行了脑部MRI检查并纳入研究。由两名经验丰富的神经放射科医生对MRI进行分析，以确定幕上和幕下脑异常。
在MMC患者中一致发现了广泛的脑异常。正如预期的那样，最常见的是脑积水（94.5%）和II型CM（89.1%）。值得注意的是，我们发现胼胝体异常的发生率很高（86.4%），主要表现为发育异常（46%）。
这些数据与以下概念一致，即与MMC相关的脑异常可以是幕下和幕上、皮质和皮质下的。需要更多的研究来将这些前脑异常与长期功能结局及其对这些患者的预后价值相关联。
