Yang M T, Chen C H, Chi C S, Mak S C
Department of Pediatrics, Taichung Veterans General Hospital, Taiwan, R.O.C.
Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi. 1996 Sep-Oct;37(5):342-8.
There were a total of 22 cases of cerebellar dysgenesis documented by brain sonogram, and/or brain computer-tomography scan, and/or brain magnetic resonance imaging (MRI) in our department over the past 10 years. There were ten males and twelve females. The mean age at diagnosis was 5.79 months. The follow-up period ranged from 2 days to 132 months. Seven cases were suspected upon prenatal examination. Three cases presented with isolated cerebellar hypoplasia, one with Dandy- Walker malformation and three with Joubert syndrome. Seven cases presented with cerebellar dysgenesis complicated with supratentorial brain dysgenesis. Among them, three had vermis hypoplasia with hypoplasia of the corpus callosum, 1 had vermis hypoplasia with holoprosencephaly, 1 had cerebellar hypoplasia with lissencephaly and hypoplasia of corpus callosum, 1 had vermis hypoplasia, agenesis of the corpus callosum and pachygyria, and 1 had cerebellar hypoplasia, hypoplasia of corpus callosum and midline cystic malformation. They all showed severe psychomotor retardation. Six cases showed chromosome anomalies. The neurological outcome for cases with isolated cerebellar hypoplasia was better than the outcome of the complicated cases. MRI is recommended for patients with microcephaly to check for the possibility of combined supratentorial brain dysgenesis. When performing MRI, a median sagittal view should be included. A classification for clinical approach was presented at the same time. In this retrospective study, this classification seemed to have benefits in prediction of clinical outcomes.
在过去10年里,我院共有22例小脑发育不全病例,通过脑超声、脑计算机断层扫描和/或脑磁共振成像(MRI)确诊。其中男性10例,女性12例。诊断时的平均年龄为5.79个月。随访时间从2天至132个月不等。7例在产前检查时被怀疑患有该病。3例表现为孤立性小脑发育不全,1例为丹迪-沃克畸形,3例为儒贝尔综合征。7例小脑发育不全合并幕上脑发育不全。其中,3例小脑蚓部发育不全合并胼胝体发育不全,1例小脑蚓部发育不全合并前脑无裂畸形,1例小脑发育不全合并无脑回畸形和胼胝体发育不全,1例小脑蚓部发育不全、胼胝体缺如和巨脑回畸形,1例小脑发育不全、胼胝体发育不全和中线囊性畸形。所有病例均表现出严重的精神运动发育迟缓。6例存在染色体异常。孤立性小脑发育不全病例的神经学预后优于合并其他病症的病例。建议对小头畸形患者进行MRI检查,以排查合并幕上脑发育不全的可能性。进行MRI检查时,应包括正中矢状面图像。同时提出了一种临床处理分类方法。在这项回顾性研究中,这种分类方法似乎对临床预后的预测有帮助。