Ippel P F, Breslau-Siderius E J, Hack W W, van der Blij H F, Bouve S, Bijlsma J B
Clinical Genetics Centre, Utrecht, The Netherlands.
Eur J Pediatr. 1998 Jun;157(6):493-7. doi: 10.1007/s004310050861.
Atelencephalic microcephaly is a lethal form of abnormal cerebral development. In atelencephaly there is a rudimentary prosencephalon; in aprosencephaly, a more severe form of cerebral malformation, both prosencephalic and diencephalic derivatives fail to develop; both conditions form the aprosencephaly/atelencephaly spectrum (AAS). In the literature 20 cases with atelencephaly or aprosencephaly have been described. Except for the brain malformation other congenital abnormalities seem to be present more often in patients with aprosencephaly. In two patients (one with atelencephaly and one with aprosencephaly) an aberration of chromosome 13 was found. We report on a prematurely born microcephalic male infant with a severely malformed calvarium with overlying rugged skin, non-fused cranial sutures, absent fontanelles, and multiple contractures. CT scan of the brain revealed neither cerebral hemispheres, nor ventricles and a diagnosis of atelencephalic microcephaly was made. In the literature two sibs have been described, products of consanguineous parents, who were the only ones with cerebellar dysgenesis. Aprosencephaly/atelencephaly spectrum in combination with cerebellar dysgenesis seems to be an autosomal recessive syndrome.
Atelencephalic microcephaly is a distinct entity and should be differentiated from anencephaly and the fetal brain disruption sequence. The aetiology of the disorder is unknown.
端脑小头畸形是一种致死性的脑发育异常形式。在端脑小头畸形中存在一个发育不全的前脑;在无前脑畸形(一种更严重的脑畸形形式)中,前脑和间脑衍生物均无法发育;这两种情况构成了无前脑畸形/端脑小头畸形谱系(AAS)。文献中已描述了20例端脑小头畸形或无前脑畸形病例。除脑畸形外,其他先天性异常似乎在无前脑畸形患者中更常出现。在两名患者(一名端脑小头畸形患者和一名无前脑畸形患者)中发现了13号染色体异常。我们报告了一名早产的小头畸形男婴,其颅骨严重畸形,头皮粗糙,颅缝未融合,囟门缺失,并有多处挛缩。脑部CT扫描显示既无大脑半球也无脑室,诊断为端脑小头畸形。文献中描述了一对近亲父母的同胞,他们是仅有的患有小脑发育不全的患者。无前脑畸形/端脑小头畸形谱系合并小脑发育不全似乎是一种常染色体隐性综合征。
端脑小头畸形是一种独特的疾病,应与无脑畸形和胎儿脑破坏序列相鉴别。该疾病的病因尚不清楚。