The association between numerical and spatial thinking manifests itself throughout various cognitive observations, concerning arithmetic problem solving as well as simple number recognition tasks. The spatial component in numerical thinking is assumed to represent the semantic processing pathway, for example, the mental representation of numerical magnitude. There is an interconnection of semantic, linguistic, and visual/symbolic pathways, which is thought to be stronger in adults than in children. During childhood, the semantic pathway is supposed to play a major part in numerical processing. In this study, we conducted a functional magnetic resonance imaging paradigm combining a mental rotation task with a number processing task. The behavioral data showed the highest error rate for two-digit numbers (not for threedigit numbers). In regard to two-digit numbers, we also found the strongest neuronal activation overlap for number processing and mental rotation in the left intraparietal sulcus. This pattern suggests that the mental inversion of digits in native German speakers might be a spatial function related to mental rotation. In terms of overcoming opposed informational input for symbolic and linguistic representation and therefore impeded informational extraction the spatial processing pathway might play a major role. To conclude, spatial training could be an effective educational approach, supporting the interconnection of numerical processing pathways.
Welcome to this special issue of Journal of Pediatric Neuroradiology (JPNR) focusing on pediatric head and neck imaging. Our goal during preparation was to address the intersection of neuroradiology, pediatric radiology, otolaryngology, neurosurgery, and pathology.
Congenital brain tumors, unlike those of older children and adults, are a rare entity, accounting for less than 2% in terms of incidence, of all childhood brain tumors. They differ in their location, histology, biological behavior, and the therapeutic response compared with those of older children. In this article, we review the most important types of congenital brain tumors mainly focusing on their imaging findings.
“As the mother of a grown son with a traumatic brain injury, I couldn't be more excited about the prospect of finding out how to repair even a small part of the damage that changed his life.” Judy Woodruff, author.
Head injuries in children are relatively common leading to a significant number of emergency room visits and hospitalizations annually. Although most injuries are minor, severe brain injury carries a significantmortality rate leading to 3,000 deaths per year in the United States. We describe the pathophysiology of traumatic brain injury in children. Appropriate imaging modalities are discussed with a specific focus on the role of computed tomography (CT) andmagnetic resonance imaging (MRI). Classic patterns of injury and associated imaging findings on CT and MRI are described. In addition, characteristic findings seen in birth-related trauma are also reviewed.
In this article, we review the most common posterior fossa pediatric neoplasms. We describe the computed tomography and magnetic resonance imaging (MRI) findings used in the initial evaluation of a pediatric brain tumors. We also discuss the advanced MRI techniques which provide information about the physiology of the tumors and play an important role in the differential diagnosis as well as in the preoperative evaluation of different tumor types.
A vein of Galen malformation (VGM) is a rare condition of the pediatric population. Our patient was diagnosed with VGM on intrauterine ultrasound. At birth, she was noted to have multiple congenital heart defects but no signs of congestive heart failure, and intervention was delayed. Our patient presented at 4 months of age with worsening hydrocephalus due to the enlargement of the VGM. A ventricular peritoneal shunt was placed. At 26 months of age, our patient was taken for embolization of the VGM. Cerebral angiography showed no VGM. We present that changes in hemodynamics after shunt placement lead to the thrombosis of the VGM.
Various congenital head and neck lesions can present in the pediatric population. In this article, we will discuss some of the more common lesions encountered in the pediatric population including thyroglossal duct anomalies, dermoid cysts, branchial cleft anomalies, vascular and lymphatic malformations. Since they are encountered frequently, it is important for the radiologists to be aware of some of the common lesions and their imaging features.
Central nervous system tumors represent the most common solid tumors of childhood. The heterogeneous group of gliomas comprises the majority of pediatric tumors while embryonal neoplasms represent the second most frequent group of tumors. Histopathological diagnosis according to World Health Organization is of great importance for defining prognosis and choosing the appropriate treatment. Recently, attempts have been made to correlate specific genomic alterations to clinical outcome. Adding molecular information to classic histology seems to improve diagnostic accuracy and risk stratification of patients.
Craniosynostosis is seen in 1 of every 2,000 births, with associated craniofacial deformities that produce significant anatomic and functional impairment. In isolated craniosynostosis, the classic clinical appearances and surgical approaches are well established. However, syndromic craniosynostosis presents with compound anatomic malformations and multisystem involvement, greatly complicating diagnosis and therapy. In such cases, imaging and genomic analysis can assist greatly in preoperative diagnosis and follow-up. This article will review the current literature on radiologic manifestations and genetic etiologies of major craniosynostosis syndromes.
Brain tumors are the most common solid tumor entity in children and constitute 15 to 20% of all childhood malignancies. All health care professionals seeing children should be able to identify signs and symptoms arising from a central nervous system (CNS) tumor and refer or investigate appropriately. Despite advances in neuroimaging, the timely diagnosis of CNS tumors remains difficult. It is well-known that any delay in diagnosis leads to further tumor progress and thus worsens the outcome and the risk of additional brain damage, thus making an early diagnosis crucial. This article reviews the presenting clinical features that characterize children with brain tumors.
Fetal head and neck (HN) anomalies represent complex diagnostic and management challenges, often requiring serial imaging and a multidisciplinary teamapproach. In this article, we will review the prenatal magnetic resonance imaging diagnosis of HN malformations, with ultrasound and postnatal imaging correlation. Key topics to be discussed include craniofacial abnormalities, posterior fossa malformations, neural tube defects, cervicofacial masses, and airway anomalies.
The aim of the this article is to give brief overview of a few classic pediatric head and neck disease processes, including congenital malformations, neoplasms, and inflammatory sequelae. Radiologists should be familiar with the imaging characteristics, associated clinical scenario and differential diagnoses of these entities to ensure proper management.
Head and neck masses continue to be a common indication for neuroradiological evaluation of pediatric patients. Etiologies include inflammatory, congenital, benign neoplastic, and malignant neoplastic lesions. The incidence of childhood head and neck malignancy is increasing, and therefore should always be included in the differential diagnosis of a pediatric patient presenting with a space-occupying lesion of the head or neck. Many factors can aid in an accurate diagnosis, including age of the patient, location of the mass, and imaging features. This article will review several benign and malignant pediatric head and neck neoplasms, as well as congenital lesions, and focus on their imaging features.
It is my pleasure to serve as the editor for the current issue of the Journal of Pediatric Neuroradiology entitled “Pediatric Brain Tumors.”
Brain tumors in children are the second most common type of pediatric tumors after leukemia and the most common occurring solid tumor. Brain tumors diagnosed during the first year of life have different features than those presenting later in childhood and are usually supratentorial. Magnetic resonance imaging is the modality of choice for the diagnosis and characterization of these tumors. Herewith, we provide a review of the imaging characteristics on conventional and advanced neuroimaging techniques of the most common supratentorial intracranial tumors in children.
Background Hypoxic-ischemic injury (HII) is a significant cause of neonatal morbidity and mortality. It had been postulated that apparent diffusion coefficient (ADC) abnormalities in term neonatal HII generally peak at 3 to 5 days after birth and subsequently "pseudonormalize" by the end of the first week. Thus, ADC values may provide a clue for timing of HII.Objective In this study, we sought to assess whether ADC values can always predict time of hypoxic ischemic insult.Methodology We prospectively analyzed 34 full-term neonates with suspected HII by diffusion-weighted (DW) magnetic resonance imaging (MRI) within 14 days after birth. DW images (DWIs) were assessed for areas of restricted diffusion at different locations that could be encountered in HII. ADC maps were generated and ADC values were calculated. Spearman correlation coefficient and receiver operating characteristic (ROC) curve analyses were performed.Results Themean age of neonates at time of MRI was 8 (+/- 4) days (range: 2-14 days). No significant correlation detected between ADC values and age of neonates at time of imaging (p = 0.183; R2 = 0.06). ROC curve analysis showed that ADC values could not discriminate between neonates who were imaged early (+/- 7 days) or later (p = 0.391; area under the curve = 0.633).Conclusion ADC values may not be capable to accurately predict time of onset in term neonates with HII. ADC values should always be interpreted in combination with both conventional and DWIs, and each case should be individualized instead of generalization.
Over the past few decades, the incidence of head and neck squamous cell carcinomas in the pediatric population and tumors associated with oncogenic human papilloma virus (HPV) has continued to increase. Previously, head and neck cancers in young patients were considered rare and-only in patients with genetic risk factors, with clinicians unaware of these neoplasms-occurring with greater frequency in younger patients, and often associated with HPV infection. This article reviews the viral oncogenic properties of HPV and Epstein-Barr virus, what the biomarker p16 represents, and the salient clinical and radiographic features of these tumors. Clinical awareness of these features is important to identify these tumors and initiate appropriate therapeutic treatment and to avoid any delay in diagnosis.
Abnormalities of the pediatric globe and optic nerve present with different clinical features than adults. While many of these lesions are benign, most have a significant impact on vision, and therefore, the radiologist can play a key role in patient care. This article will review the radiologic features of retinoblastoma, themost common pediatric orbital tumor, as well as other congenital abnormalities such as persistent hyperplastic primary vitreous, Coats disease, and retinopathy of prematurity. Abnormalities of globe development, such as coloboma and vascular lesions, will also be discussed, as these should prompt imaging of the entire neuroaxis due to association with systemic syndromes. Tumors of the optic nerve can also unmask an underlying syndrome, the most common being an optic nerve glioma occurring in the setting of neurofibromatosis type I.
