Ognerubov NA, Antipova TS, Mirsalimova OO, Zemur MA. Agenesis of the corpus callosum combined with cerebral abnormalities: Clinical and diagnostic features. Consilium Medicum. 2024;26(11):767–775.
DOI: 10.26442/20751753.2024.11.203032
Агенезия мозолистого тела в сочетании с церебральными аномалиями: клинико-диагностические особенности
Огнерубов Н.А., Антипова Т.С., Мирсалимова О.О., Земур М.А. Агенезия мозолистого тела в сочетании с церебральными аномалиями: клинико-диагностические особенности. Consilium Medicum.
2024;26(11):767–775. DOI: 10.26442/20751753.2024.11.203032
Ognerubov NA, Antipova TS, Mirsalimova OO, Zemur MA. Agenesis of the corpus callosum combined with cerebral abnormalities: Clinical and diagnostic features. Consilium Medicum. 2024;26(11):767–775.
DOI: 10.26442/20751753.2024.11.203032
Обоснование. Агенезия мозолистого тела (АМТ) – полное или частичное отсутствие МТ, которое является одним из наиболее распространенных врожденных пороков развития головного мозга (ГМ) с частотой встречаемости 1,4 случая на 10 тыс. живорождений. Цель. Представить клинические и диагностические особенности 4 пациентов с АМТ. Материалы и методы. Под наблюдением находились 4 пациента с АМТ в возрасте 11, 12, 13 и 50 лет, из них 3 – лица мужского пола, 1 – девочка 13 лет. Всем больным проведены неврологическое обследование с оценкой когнитивных, психических расстройств и электроэнцефалография. Для выявления повреждений анатомической структуры ГМ пациентам выполнена магнитно-резонансная томография (МРТ) в стандартных режимах. С этой целью применяли магнитно-резонансный томограф с напряженностью магнитного поля 1,5 Тл. Результаты. У 2 пациентов – мужчины 50 лет и мальчика 12 лет – заболевание протекало бессимптомно. В других 2 случаях имелся явный неврологический и когнитивный дефицит. У мальчика 11 лет родители, бабушка и дедушка умерли от хронического алкоголизма. При неврологическом обследовании у него выявлены признаки поражения пирамидного пути, а также выраженные когнитивные нарушения в виде глубокой умственной отсталости, включая задержку психоречевого развития. Девочка 13 лет страдает тяжелой умственной отсталостью с нарушением речи. В обоих случаях АМТ ассоциировалась с эпилепсией с частотой приступов от 6 раз в год у девочки и до 15 раз в месяц у мальчика. Наличие грубого неврологического и когнитивного дефицита представляет социальные трудности, поскольку такие пациенты нуждаются в реабилитации и постоянном уходе. Во всех случаях диагноз АМТ поставлен по результатам МРТ ГМ, которая является методом выбора. МРТ позволяет оценить анатомическую структуру МТ и наличие других аномалий ГМ. Полная агенезия установлена в 3 случаях, включая девочку, а у 1 пациента – мальчика 12 лет – выявлена частичная агенезия с сохранением валика. У всех больных агенезия сочеталась с врожденными пороками развития ГМ, а именно с отсутствием прозрачной перегородки, межполушарной и порэнцефалической кистой, платибазией и венозной мальформацией лобной доли. Заключение. АМТ является редкой врожденной аномалией развития ГМ. Согласно полученным данным агенезия преобладает у лиц мужского пола. Полная АМТ диагностирована у 3 пациентов, частичная – у 1. К факторам риска следует отнести употребление алкоголя матерью во время беременности. Клиническая картина является разнообразной: от бессимптомного течения до выраженных когнитивных нарушений в виде тяжелой и глубокой умственной отсталости, эпилепсии и аутистических расстройств с неврологическим дефицитом, включая поражение пирамидного пути. Основным методом диагностики является МРТ, которая позволяет выявить анатомические изменения МТ и других структур ГМ.
Background. Agenesis of the corpus callosum (ACC) is the total or partial absence of CC, one of the most common congenital brain malformations, with an incidence rate of 1.4 cases per 10,000 live births. Aim. To describe the clinical and diagnostic features of 4 patients with ACC. Materials and methods. Four patients with ACC aged 11, 12, 13, and 50 years were managed, of whom 3 were males, and 1 was a 13-year-old girl. All patients underwent a neurological examination, which assessed cognitive and mental disorders and electroencephalography. Patients underwent magnetic resonance imaging (MRI) in standard modes using a magnetic resonance imaging scanner with a magnetic field intensity of 1.5 T to detect damage to the brain's anatomical structure. Results. The disease was asymptomatic in 2 patients (a 50-year-old man and a 12-year-old boy). In the other 2 cases, there was an apparent neurological and cognitive deficit. The boy's parents and grandparents died of chronic alcoholism at the age of 11. During a neurological examination, he showed signs of damage to the pyramidal tract, as well as pronounced cognitive impairment with profound mental retardation, including delayed psycho-speech development. The 13-year-old girl suffers from severe mental retardation with speech impairment. In both cases, ACC was associated with epilepsy with a seizure frequency ranging from 6 times a year in the girl and up to 15 times a month in the boy. The gross neurological and cognitive deficits cause social difficulties since such patients need rehabilitation and ongoing care. In all cases, the diagnosis of ACC is based on the results of brain MRI, which is the method of choice. MRI enables assessment of the CC anatomical structure and the presence of other brain abnormalities. Complete agenesis was established in 3 cases, including a girl, and in one patient – a 12-year-old boy – partial agenesis with intact splenium was detected. In all patients, agenesis was combined with brain congenital malformations, namely with the absence of the septum pellucidum, interhemispheric and porencephalic cyst, basilar invagination, and venous malformation of the frontal lobe. Conclusion. ACC is a rare congenital brain malformation. According to the data, agenesis is more common in males. Complete ACC was diagnosed in 3 patients and partial ACC in 1. Risk factors include maternal alcohol consumption during pregnancy. The clinical presentation is diverse: from an asymptomatic course to severe cognitive impairment with severe and profound mental retardation, epilepsy, and autistic disorders with neurological deficits, including damage to the pyramidal tract. The primary diagnostic method is MRI, which detects anatomical changes in CC and other brain structures.
Keywords: cerebral anomalies, combination, agenesis of the corpus callosum, clinical presentation, diagnosis, magnetic resonance imaging
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________________________________________________
1. Weise J, Heckmann M, Bahlmann H, et al. Analyses of pathological cranial ultrasound findings in neonates that fall outside recent indication guidelines: results of a population-based birth cohort: survey of neonates in Pommerania (SNiP-study). BMC Pediatr. 2019;19(1):476. DOI:10.1186/s12887-019-1843-6
2. Milovanova OA, Tarakanova TYu, Pronicheva YuB, et al. Agenesis of the corpus callosum associated with hereditary syndromes. Annals of Clinical and Experimental Neurology. 2017;10(2):62-7 (in Russian).
3. Schell-Apacik CC, Wagner K, Bihler M, et al. Agenesis and dysgenesis of the corpus callosum: clinical, genetic and neuroimaging findings in a series of 41 patients. Am J Med Genet A. 2008;146A(19):2501-11. DOI:10.1002/ajmg.a.32476
4. Jeret JS, Serur D, Wisniewski K, Fisch C. Frequency of agenesis of the corpus callosum in the developmentally disabled population as determined by computerized tomography. Pediatr Neurosci. 1985;12(2):101-3. DOI:10.1159/000120229
5. Grogono JL. Children with agenesis of the corpus callosum. Dev Med Child Neurol. 1968;10(5):613-6. DOI:10.1111/j.1469-8749.1968.tb02944.x
6. Kumar P, Burton B. Congenital Malformations: Evidence-Based Evaluation and Management. 2007.
7. De León Reyes NS, Bragg-Gonzalo L, Nieto M. Development and plasticity of the corpus callosum. Development. 2020;147(18):dev189738. DOI:10.1242/dev.189738
8. Popoola O, Olayinka O, Azizi H, et al. Neuropsychiatric Manifestations of Partial Agenesis of the Corpus Callosum: A Case Report and Literature Review. Case Rep Psychiatry. 2019;2019:5925191. DOI:10.1155/2019/5925191
9. Nagwa S, Saran S, Sharma Y, Kharbanda A. Imaging features of complete agenesis of corpus callosum in a 3-year-old child. Sudan J Paediatr. 2018;18(2):69-71. DOI:10.24911/SJP.106-1523336915
10. Gaillard F, Walizai T, Campos A, et al. Dysgenesis of the corpus callosum. Reference article. Radiopaedia.org. DOI:10.53347/rID-864. Accessed: 18.10.2024.
11. Smith CJ, Smith ZG, Rasool H, et al. Unravelling the Clinical Co-Morbidity and Risk Factors Associated with Agenesis of the Corpus Callosum. J Clin Med. 2023;12:3623. DOI:10.3390/jcm12113623
12. Kier EL, Truwit CL. The normal and abnormal genu of the corpus callosum: an evolutionary, embryologic, anatomic, and MR analysis. AJNR Am J Neuroradiol. 1996;17(9):1631-41.
13. Das JM, Geetha R. Corpus Callosum Agenesis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available at: https://www.ncbi.nlm.nih.gov/books/NBK540986. Accessed: 18.10.2024.
14. Mahmoud Q. Agenesis of the corpus callosum with interhemispheric cyst. Case study. Radiopaedia.org. DOI:10.53347/rID-171818. Accessed: 18.10.2024.
15. Barkovich AJ, Simon EM, Walsh CA. Callosal agenesis with cyst: a better understanding and new classification. Neurology. 2001;56(2):220-7. DOI:10.1212/wnl.56.2.220
16. Ho M, Walizai T, Campos A, et al. Porencephaly. Reference article. Radiopaedia.org. DOI:10.53347/rID-7281. Accessed: 18.10.2024.
17. Marathu KK, Vahedifard F, Kocak M, et al. Fetal MRI Analysis of Corpus Callosal Abnormalities: Classification, and Associated Anomalies. Diagnostics (Basel). 2024;14(4). DOI:10.3390/diagnostics14040430
18. Aminoff MDzh, Grinberg DA, Saimon RP. Klinicheskaia nevrologiia. Moscow: MEDpress-inform, 2009 (in Russian).
19. Sowell ER, Mattson SN, Thompson PM, et al. Mapping callosal morphology and cognitive correlates: effects of heavy prenatal alcohol exposure. Neurology.
2001;57(2):235-44. DOI:10.1212/wnl.57.2.235
20. Tang PH, Bartha AI, Norton ME, et al. Agenesis of the corpus callosum: an MR imaging analysis of associated abnormalities in the fetus. AJNR Am J Neuroradiol. 2009;30(2):257-63. DOI:10.3174/ajnr.A1331
21. Stevenson RE, Hall JG. Human Malformations and Related Anomalies. NY: Oxford University Press, 2006.
22. Morris JK, Wellesley DG, Barisic I, et al. Epidemiology of congenital cerebral anomalies in Europe: a multicentre, population-based EUROCAT study. Arc Dis Child.
2019;104(12):1181-7. DOI:10.1136/archdischild-2018-316733
23. Brown WS, Paul LK. The Neuropsychological Syndrome of Agenesis of the Corpus Callosum. J Int Neuropsychol Soc. 2019;25(3):324-30. DOI:10.1017/S135561771800111X
24. Mitchell TN, Free SL, Williamson KA, et al. Polymicrogyria and absence of pineal gland due to PAX6 mutation. Ann Neurol. 2003;53(5):658-3. DOI:10.1002/ana.10576
25. Milovanova OA, Tarakanova TYu, Pronicheva YuB, et al. Agenesis of the corpus callosum associated with hereditary syndromes. Annals of Clinical and Experimental Neurology. 2017;11(2):62-7 (in Russian).
26. Ghavipisheh M, Jahromi LR, Ahrari I, Jahromi MG. Complete agenesis of corpus callosum with a rare neuropsychiatric presentation: A case report. Radiol Case Rep.
2023;18(4):1442-45. DOI:10.1016/j.radcr.2023.01.031
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1ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России, Москва, Россия; 2Федеральная сеть центров ядерной медицины «ПЭТ-Технолоджи», Москва, Россия; 3Онкорадиологический центр «ПЭТ-Технолоджи», Подольск, Россия
*ognerubov_n.a@mail.ru
________________________________________________
Nikolai A. Ognerubov*1, Tatiana S. Antipova2, Olga O. Mirsalimova2, Mikhail A. Zemur3
1Russian Medical Academy of Continuous Professional Education, Moscow, Russia; 2Federal Network of Nuclear Medicine Centers "PET-Technology", Moscow, Russia; 3PET-Technology Oncoradiology Center, Podolsk, Russia
*ognerubov_n.a@mail.ru