AJNR Blog » Congenital abnormalities

Educational presentation: septo-optic dysplasia

MCastillo — Tue, 24 Aug 2010 17:26:00 +0000

Here is a nice, concise presentation on SOD. Although this is not an uncommon entity it may be sometimes confusing. I hope that trainees as well as neuroradiologists will enjoy and find it helpful.

SOD (NXPowerLite)

Propanolol as treatment for infantile hemangiomas

MCastillo — Mon, 19 Oct 2009 16:25:12 +0000

Infantile Hemangioma Propanolol Treatment

You may have heard that Propanolol is currently being used as treatment for some infantile hemangiomas of both types (RICH and NICH). In this presentation prepared for our weekly case conference by Mr. Danilo Bernardo the results of such therapy are illustrated and discussed.

Educational Presentation: Congenital Anomalies of the Pituitary Gland

MCastillo — Tue, 08 Sep 2009 13:31:10 +0000

Congenital Pituitary Abns (NXPowerLite)

Here is the third on my series of educational presentations. It deals with embryology, anatomy and congenital abnormalities of the pituitary gland. I need to acknowledge that this one was authored by Drs. Spampinato, Camacho and Grimme during their fellowships here at UNC and was previously shown at ASNR. Like the other two presentations, it is compressed and it is not protected so please give credit to its source if you decide to use it for teaching purposes elsewhere.

Anomalies After Exposure to Methotrexate in the 1st Trimester

Marcela Posada — Tue, 11 Aug 2009 11:49:32 +0000

This is a 2 day-old term baby with history of methotrexate exposure during first trimester as an abortion attempt. No other relevant clinical history. The MRI study shows large bilateral choroid plexus cysts, partial sacral agenesis and a filar lipoma. If anyone has had experience with this situation, please let us know.

Methotrexate is a folic acid antagonist, which is known to have teratogenic effects in the first trimester of gestation. It interrupts the synthesis of thymidylate, purine nucleotides, and some amino acids, thereby interfering with the formation of DNA, RNA, and proteins. Methotrexate has multiple therapeutic uses in women of reproductive age such as treatment of neoplastic disease, psoriasis, rheumatoid arthritis, lupus, ulcerative colitis, ectopic pregnancy and as well as an agent for induce abortion. Failure rate of abortion is 2-10% and there are reports of normal pregnancy outcomes.

There are well described congenital anomalies resulting from methotrexate exposure in first trimester of pregnancy; dose dependence is unclear. Cranial dysostosis, hypertelorism, external ear anomalies, micrognathia and posterior cleft palate have been described. Multiple skeletal and axial anomalies are also noted.

We have found two case reports in the literature of choroid plexus cysts after methotrexate exposure during the first trimester of pregnancy. The caudal vertebral anomalies have been reported mostly in rats.

ASL Perfusion in Cortical Dysplasia

MCastillo — Tue, 17 Feb 2009 13:58:58 +0000

Arterial spin labeling perfusion is becoming an important clinical tool. We find it particularly useful in children in whom it is difficult to obtain contrast enhanced MR perfusion due to the smaller size of needles used. Here is a case of a balloon cell type cortical dysplasia in the right temporoparietal region with low cerebral blood flow on the ASL study. I think that our Blogsite is the ideal place to share these cases with the rest of the Neuroradiology community. Similar findings to the ones shown here were reported in the following article found in the publication preview section of www.ajnr.org:

Pollock J, Whitlow C, Tan H, et al. Pulsed Arterial Spin-Labeled MR Imaging Evaluation of Tuberous Sclerosis. AJNR Am J Neuroradiol. 10.3174/ajnr.A1428