Pattern of Brain Abnormalities on Magnetic Resonance Imaging in Children with Global Developmental Delay Attending a Tertiary Hospital
Sanjida Ahmed, Syeda T. Alam, Kanij Fatema, Kazi A. Islam, Bikush C. Paul, Aireen Akhter, Paramita Barua, Zannatul Ferdouse, Shaheen AkhterAbstract
Background:
Child development, a continuous process from conception to maturity, involves the maturation of brain function distinct from mere physical growth. Variations in developmental rates among children stem from genetic, environmental, and potential medical factors. Development spans various domains such as motor skills, language proficiency, and cognitive growth. Developmental delay, when milestones are not met at expected ages, can be global or specific across developmental domains. Causes range from non-progressive factors like brain malformations to progressive issues like metabolic or neurodegenerative processes.
Aim:
To identify the pattern of brain abnormalities detected by magnetic resonance imaging (MRI) and its proportion in children with global developmental delay (GDD).
Materials and Methods:
A cross-sectional study was conducted at the Department of Pediatric Neurology, Institute of Pediatric Neurodisorder and Autism, Bangladesh Medical University. Forty-seven children diagnosed with GDD, aged 3 months to 5 years, were enrolled. Detailed history taking, physical examination, followed by MRI scans were done using a 1.5 Tesla Siemens Magnetom Avanto machine. Radiologists and pediatric neurologists reviewed the MRI findings, categorizing them into anatomical and etiological classifications.
Results:
The study included children aged between 3 months and 5 years, with a mean age of 1.91 ± 1.35 years. Most cases were in the 1–2-year age group. Perinatal history revealed various factors such as prematurity, low birth weight, and perinatal asphyxia. The majority of MRI findings were abnormal, with traumatic or neurovascular issues being the most common etiological type. Cortical and subcortical gray matter involvement was predominant, followed by periventricular white matter abnormalities. Neuroimaging findings provided crucial insights into structural brain anomalies, guiding further investigations and potential interventions for these children with GDD.
Conclusion:
A high percentage of MRIs of the brain in infants and children with GDD displayed abnormal findings. Cortical and subcortical gray matter involvement was the most prevalent anatomical abnormality, while neurovascular causes constituted the leading etiological type of brain involvement on MRI in children with GDD.