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2.1
Mega-Cisterna Magna
Mega Cisterna Magna

Presentation

This paper presents the clinical diagnosis with vertebral angiogrraphy, pneumoencephalography and computed tomography. [jkns.or.kr]

Case Presentation A two-year-old Caucasian male presented to our clinic following a referral for an abnormal head shape. He was developmentally normal and the mother reported no symptoms. [cureus.com]

10.1055/b-0040-176854 18 Mega Cisterna Magna 18.1 Case Presentation 18.1.1 History A 15-year-old female patient presents with a history of a one-time seizure episode. 18.2 Imaging Analysis 18.2.1 Imaging Findings and Impression Brain MR images sagittal [radiologykey.com]

An enlarged posterior fossa can sometimes be present 6. History and etymology The term was coined by the Belgian neurosurgeon Richard Gonsette (1929-2014) 8 in 1962, in patients with cerebellar atrophy 7. [radiopaedia.org]

Entire Body System

  • Inguinal Hernia

    hernia), central nervous system (cerebral and cerebellar atrophy, mega cisterna magna, mental motor retardation, convulsions, corpus callosum dysgenesis, cranial bone defects, and spina bifida occulta), and genitourinary anomalies (renal hypoplasia and [hindawi.com]

Musculoskeletal

  • Hip Dislocation

    dislocation, and polydactyly), respiratory, gastrointestinal (umbilical and inguinal hernia), central nervous system (cerebral and cerebellar atrophy, mega cisterna magna, mental motor retardation, convulsions, corpus callosum dysgenesis, cranial bone [hindawi.com]

Psychiatrical

  • Behavior Disorder

    There was no reported evidence of neurologic disorder or developmental delay on available follow-up spanning up to 69 months for 8 of the patients.[14] These results may also be of limited value as cognitive and behavioral disorders may be difficult to [ncbi.nlm.nih.gov]

  • Social Isolation

    Her symptoms began with social isolation, decrease of self-care, and positive psychotic symptoms. Neurological examination and EEG examination were normal, but mega cisterna magna was discovered in her cranial magnetic resonance imaging scan. [psychiatry-psychopharmacology.com]

Neurologic

  • Paresthesia

    Physical examination during the perinatal period should include a search for additional neurologic and systemic malformations, including headache, nausea/vomiting, paresthesias, weakness, ataxia, etc. [ncbi.nlm.nih.gov]

  • Neurologic Manifestation

    Clinical manifestations are conflicting but appear more favorable in recent studies with a lower incidence of neurologic manifestations.[14] Manifestations of mega cisterna magna may include specific cognitive parameters, including memory, executive function [ncbi.nlm.nih.gov]

Workup

[…] with a low‐risk serum screen for aneuploidy that the finding of an isolated mildly enlarged cisterna magna with otherwise normal intracranial anatomy, especially in the third trimester, is usually a normal variant and therefore does not require further workup [onlinelibrary.wiley.com]

Treatment

Treatment with amisulpride 1200 mg/day resulted in a 30% decrease in PANSS score within 2 months. Then galantamine 8 mg/day was added and PANSS score decreased further by 27% within 2 weeks. [operativeneurosurgery.com]

[…] of the newborn a few hours after with cPMP through a central line with good results.8 After a daily treatment with cPMP, the patient manifested an almost normal neurodevelopment.8 Lubout et al published a case where the treatment is administered shortly [dovepress.com]

Treatment / Management No specific treatment is necessary for patients with incidentally discovered mega cisterna magna. [ncbi.nlm.nih.gov]

Prognosis

One set of data indicates that nearly 80% of parents prefer to abort fetuses identified with PFAs in some parts of the world.1 This may be unwarranted, given that cases of isolated MCM have a favorable developmental prognosis. [consultant360.com]

Prognosis: Normal neurodevelopment. Recurrence: No increased risk of recurrence. [fetalmedicine.org]

We conclude that overall, the prognosis for these posterior fossa defects is grim but not uniformly fatal. The presence of other anomalies is associated with the worst prognosis. [childnervoussystem.blogspot.com]

[…] mega cisterna magna has been associated with: Infarction Inflammation/infection: particularly cytomegalovirus Chromosomal abnormalities: especially trisomy 18 However, when a mega cisterna magna occurs as an isolated finding with normal ventricles the prognosis [operativeneurosurgery.com]

The prognosis for mega cisterna magna is good when the condition occurs with normal ventricles in an isolated finding. It is usually observed on a CT/MRI or ultrasound. [reference.com]

Etiology

Rarely, both of these conditions may have a common underlying etiology that may indicate a causal relationship. Further studies are required to establish a causal relationship between the mega cistern magna and the psychiatric disorders. [neuro.psychiatryonline.org]

Appropriate evaluation, including magnetic resonance imaging (MRI) of the brain with and without contrast, should be obtained to rule out other etiologies. For mega cisterna magna, there is no indicated specific treatment or surgical intervention. [ncbi.nlm.nih.gov]

Epidemiology

Epidemiology A mega cisterna magna is thought to occur in approximately 1% of all brains imaged postnatally. Associations Especially if noted antenatally, a mega cisterna magna has been associated with infarction inflammation and infection (e.g. [medicalopedia.org]

Epidemiology A mega cisterna magna is thought to occur in ~1% of all brains imaged postnatally. [operativeneurosurgery.com]

Epidemiology. 2005;16(1):87-92. Liu Z, Han J, Fu F, et al. Outcome of isolated enlarged cisterna magna identified in utero: experience at a single medical center in mainland China. Prenat Diagn. 2017;37(6):575-582. [consultant360.com]

Kolar JC: An epidemiological study of nonsyndromal craniosynostoses. [cureus.com]

Epidemiology and Demographics The Dandy-Walker complex is a genetically sporadic disorder that occurs one in every 25,000 live births, mostly in females. [wikidoc.org]

Pathophysiology

Discussion Considering the pathophysiology of KLS, the hypothalamic hypo-metabolism may implicate sleep regulation, control of food intake, and sexual behavior. [scirp.org]

These studies may be particularly valuable in guiding studies on the pathophysiology and treatment of mood and psychotic disorders. Acknowledgments Fig. 1. [e-jyms.org]

[…] role in coordination and motor functions.1 Besides its involvement in motor and vestibulo-ocular regulation, it is considered to be involved in modulation of mood.2 Cerebellar structures, especially the vermis, are considered to be associated with the pathophysiology [ncbi.nlm.nih.gov]

Pathophysiology: Dandy-Walker malformations are formed during embryogenesis. Insults of varying severity to both the developing cerebellar hemispheres and fourth ventricle currently are believed to be the genesis of the anomaly. [medicaljournal.blogspot.com]

Prevention

Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. ‏ الصفحة 332 - Crane JP, LeFevre ML, Winborn RC, et al. [books.google.com]

Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. ‎ Pagina 332 - Crane JP, LeFevre ML, Winborn RC, et al. [books.google.ro]

Recently, it has been seen that administering cPMP as substitution therapy does not improve the brain damage already produced but prevents its progressive worsening.1,2,8 In 2012, Hitzert et al published a case diagnosed prenatally, induction of labor [dovepress.com]

Consequently, it also suggested that a certain and possibly large subset of autism cases may actually be preventable with early treatment. [medium.com]

Poor perinatal outcome associated with vasa previa: is it preventable? A report of three cases and review of the literature. Ultrasound Obstet Gynecol 1998;12(6):430–3. Review. [glowm.com]

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