Can a Cerebral Congenital Anomaly Present in Adulthood?

Abstract

Colpocephaly, a congenital anomaly in the ventricles, is usually discovered early in infancy and rarely during adulthood. Partial or complete agenesis of the corpus callosum or Chiari malformations (developmental arrest of white matter formation in early fetal development) can lead to abnormal asymmetrical ventricular enlargement. Minimal literature about colpocephaly is available for clinicians, making diagnosis and treatment very challenging. Colpocephaly in adults is an infrequent condition, mostly found as an incidental finding with no neurological or cognitive impairment. Symptoms usually represent the affected lobe in the brain as our patient's visual hallucination may be attributed to the lesioned occipital horn. Differentiating from normal pressure hydrocephalus, representing new-onset dementia, can help avoid unnecessary procedures. Neurological and psychiatric consultation should be practiced to exclude other causes of neurological and cognitive impairment. While there is no definitive treatment for this condition, seizure prophylaxis has been helpful. Cognitive behavioral therapy, psychotherapy, and social skills training are recommended in some literature. Typical and atypical antipsychotics can control symptoms with uncertain efficacy.

Colpocephaly in an adult: A rare case report

“…Review of current literature suggests colpocephaly is often an incidental diagnosis in adults. Adult patients usually present with nonspecific symptoms such as headache [1 , 2 , 3 , 10] , dizziness [2 , 6] , seizures [6 , 11] , vertigo [1] , nausea [6] , motor abnormalities [16] , sensory abnormalities [12] , cognitive abnormalities [15 , 17] , intellectual disability [18] , learning disability [17] , gait instability and falls [9] , loss of consciousness [13] and visual hallucinations [19] . Gungor et al reported a case with postmortem diagnosis of colpocephaly in a patient with a lifelong history of poor academic performance [20] .…”

“…Asymptomatic adults in whom colpocephaly is diagnosed incidentally usually require no treatment [3 , 11] . For symptomatic adult patients, management is symptomatic: the most common example being antiepileptics for patients presenting with seizures [11 , 12 , 19] . Our patient was prescribed antiepileptics due to the symptoms reported by her family as well as abnormal EEG findings.…”

“…Our patient was prescribed antiepileptics due to the symptoms reported by her family as well as abnormal EEG findings. For patients presenting with cognitive or neurological symptoms, a multidisciplinary approach involving neurology, occupational therapy, speech therapy, and physiotherapy can be beneficial [1 , 19] .…”

Acute Lower Lip Swelling: A Mere Anaphylactic Reaction or a Rare Abscess Location?

“…Pott's puffy tumor is osteomyelitis of the skull bones, leading to forehead swelling. It occurs most commonly secondary to the direct spread of bacterial infection from the surrounding tissues, such as the nasal cavity, sinuses, or oral cavity [ 13 ]. Angular cheilitis, a common, non-contagious, inflammatory condition affecting the corners of the mouth or oral commissures can also develop in IBD or other conditions such as eczema, vitamin B deficiency, or excessive saliva.…”