Gray matter shift

Introduction Gray matter heterotopia (GMH) refers to a congenital malformation that accumulates between the ependymal membrane and the surface cortex during the development of the cerebral cortex during embryonic development. It can be seen in epilepsy patients in adults and children, which can exist alone or with malformations of the nervous system or other systems. The cerebral gray matter ectopic is caused by the inability of the proliferating neuroblasts to move from the cerebral ventricle to the gray matter in time during embryonic development. A typical gray matter island is located around the ventricles and can hang over the ependymal membrane and protrude into the lateral ventricle. The large focal gray matter is ectopic, located in the center of the semi-oval, and can have a mass effect.

Cause

The cerebral gray matter ectopic is caused by the inability of the proliferating neuroblasts to move from the periphery of the ventricles to the gray matter (the darker part of the central portion visible on the transverse section of the spinal cord is called "grey matter") during embryonic development. A typical gray matter island is located around the ventricles and can hang over the ependymal membrane and protrude into the lateral ventricle. The large focal gray matter is ectopic, located in the center of the semi-oval, and can have a mass effect.

an examination

Related inspection

Brain CT examination of brain MRI examination of brain ultrasound

[clinical performance]

Small focal gray matter ectopic is generally asymptomatic, typical symptoms often have mental retardation, seizures and abnormal brain development.

[Image performance]

1.CT performance:

1 The ectopic gray matter is located in the semi-oval center or the periventricular white matter area, showing a relatively high density, which is equal to the normal brain cortex density.

2 Enhanced scan showed that the lesion was consistent with the enhancement of the normal cerebral cortex.

3 no edema around the stove.

4 can be associated with microcephaly, cerebellar hypoplasia and so on.

2.MR performance:

1 gray matter signal appears in the white matter of the brain, connected or not connected with the cortex, that is, the T1 weight is slightly lower, and the T2 weight is slightly higher.

2 large gray matter ectopic with place-holder effect, compression of ventricle deformation, should be differentiated from better differentiated glioma.

3 often combined with cerebral schizophrenia or other malformations.

4 no enhancement after enhancement.

Differential diagnosis

Gray matter abnormalities: cerebral gray matter ectopic is a manifestation of abnormal gray matter.

Cortical gliosis: pathological changes such as cortical gliosis, infarction and calcification, subcortical vacuolization, abnormal enlargement of the large cerebral vein, and associated with many small arteries. The mechanism of brain injury is mainly arterial stealing, cerebral ischemia secondary to heart failure, hemorrhagic infarction, lesion compression and surgical trauma.

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