Thalamic involvement in a patient with kernicterus

Yüksel, Yılmaz; Ekinci, Gazanfer

doi:10.1007/s003300100993

Cited by 20 publications

(13 citation statements)

References 7 publications

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“…The posteromedial border of the GP has been shown by MR imaging to be the most sensitive area to kernicterus [8]. Signal changes in the thalamus and subthalamic nucleus have also been reported [9][10][11]. However, in our study, which was conducted during the acute period of progression, we did not observe any site Fig.…”

Section: Discussioncontrasting

confidence: 64%

Hyperintense globus pallidus on T1-weighted MR imaging in acute kernicterus: is it common or rare?

et al. 2004

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Globus pallidus involvement is a well-known magnetic resonance (MR) imaging finding of acute kernicterus. However, it is not clear how early the involvement of globus pallidus occurs and whether or not it is seen in every case. Therefore, we aimed to investigate the globus pallidus involvement in 13 neonates with acute kernicterus by MR imaging. Thirteen neonates who were admitted with jaundice, encephalopathy and indirect hyperbilirubinemia (mean, 37.0 mg/dl) were prospectively evaluated with cranial MR imaging. Pathological signal changes were noted concerning the globus pallidus. Eight of the 13 patients demonstrated bilateral, symmetric increased signal intensity in the globus pallidus on T1-weighted MR imaging. These lesions were not apparent on T2-weighted images. Multiple parenchymal punctuate T1 hyperintense lesions were detected in one patient without globus pallidus involvement. This appearance was consistent with hemorrhage. The MR imaging findings of the other four patients showed no evidence of abnormality. The symmetric involvement of globus pallidus seen as hyperintense on T1-weighted MR imaging is a common and characteristic finding of acute kernicterus.

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Section: Discussioncontrasting

confidence: 64%

Hyperintense globus pallidus on T1-weighted MR imaging in acute kernicterus: is it common or rare?

et al. 2004

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“…Las imágenes muestran frecuentemente hiperintensidad a nivel del globo (43,44,45) pálido, tálamo y núcleos subtalámicos .…”

Section: Signos Y Síntomas De La Encefalopatíaunclassified

Neonatal hyperbilirubinemia, acute bilirubin encephalopathy and Kernicterus: The conti-nuum is still valid in the 21st century

Mesquita¹,

Casartelli²

2017

Pediatr. (Asunción)

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Pediatr (Asunción RESUMENAunque la ictericia afecta a más de la mitad de los neonatos en la primera semana de vida, sólo un grupo de ellos pueden desarrollar hiperbilirrubinemia severa y estar en riesgo de desarrollar encefalopatía bilirrubínica. La afectación neurológica puede presentarse con un cuadro agudo (la encefalopatía bilirrubínica aguda), la cual puede o no progresar a una forma crónica (Kernicterus), o con una constelación de síntomas sensoriales, motores y cognitivos, subagudos o crónicos, dependiendo de la presencia de factores de riesgo que aumentan la susceptibilidad al daño neurológico. La bilirrubina libre interactúa con citoquinas inflamatorias y es la responsable del daño neuronal y de las células de la glía en el sistema nervioso central. A pesar de las diferentes medidas de prevención de hiperbilirrubinemia severa, se siguen reportando casos de Kernicterus sobre todo en países en vías de desarrollo, en algunos de los cuales constituyen un problema de salud pública.Palabras claves: Hiperbilirrubinemia neonatal; encefalopatía bilirrubínica; Kernicterus; ictericia. ABSTRACTAlthough jaundice affects more than half of infants in the first week of life, only a few of them develop severe hyperbilirubinemia and are at risk of developing bilirubin encephalopathy. Neurological involvement may occur acutely (acute bilirubin encephalopathy,) which may or may not progress to a chronic form (Kernicterus), or with a constellation of sensory, motor and cognitive, subacute or chronic symptoms, depending on the presence of risk factors that increase susceptibility to neurological damage. Free bilirubin interacts with inflammatory cytokines and is responsible for neuronal and glial cell damage in the central nervous system. Despite different methods to prevent severe hyperbilirubinemia, Kernicterus cases continue to be reported, especially in developing countries, including some where this condition constitutes a public health problem.

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“…In the case described, no alterations were identified on the brain imaging tests that could suggest a diagnosis of BE. By means of the MRI, in most cases, there is a symmetrical bilateral hypersignal in the hippocampus, thalamus, subthalamus, and globus pallidus in T1 and T2 (11) . Alterations in the globus pallidus correspond to the preferential areas for non-conjugated bilirubin deposits (9) .…”

Section: Case Reportmentioning

confidence: 99%

“…However, MRI alterations are not always correlated with the clinical picture (12) . Transfontanelle ultrasound, despite being more practical, has low sensitivity and specificity, and brain axial computed tomography is no more sensitive than the MRI (11) . Another important component of BE refers to the occurrence of auditory alterations (13,14) .…”

Section: Case Reportmentioning

confidence: 99%

Bilirubin encephalopathy due to Rh incompatibility

Castilho

Vargas

Pinsuti

et al. 2011

Einstein (São Paulo)

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The authors present the case of a newborn of an Rh-factorsensitized mother, who received early hospital discharge while icteric only to be readmitted at an Emergency Service at five days of age with signs of kernicterus. Despite treatment given, the neonate progressed with a clinical picture of bilirubin encephalopathy. The lack of interaction between the obstetric and neonatal teams, premature hospital discharge, and lack of concern of neonatologists with jaundice in a full-term infant are highlighted as causes of a condition that should have disappeared if there had been adequate prevention.

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Thalamic involvement in a patient with kernicterus

Abstract: We report the MR imaging findings of a 16-month-old boy with dyskinetic cerebral palsy resulting from kernicterus. T2-weighted images showed symmetric bilateral hyperintensity in the thalamus in addition to the globus pallidus.

Cited by 20 publications

References 7 publications

Hyperintense globus pallidus on T1-weighted MR imaging in acute kernicterus: is it common or rare?

Hyperintense globus pallidus on T1-weighted MR imaging in acute kernicterus: is it common or rare?

Neonatal hyperbilirubinemia, acute bilirubin encephalopathy and Kernicterus: The conti-nuum is still valid in the 21st century

Bilirubin encephalopathy due to Rh incompatibility

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