User:Ellen.white4/Ulegyria

WIkipedia Proposal: Ulegyria

Ellen White, Sarah Lord, Arjun Gajulapalli

The following is our proposal for our project on Ulegyria. Ellen White, Arjun Gajulapalli and myself have outlined information and set up a possible format for our page. We will assign each group member a subsection within our topic but all group members will be able to contribute to all subsections and in addition, all group members will be responsible for editing the information. We will meet periodically to ensure all group members are on the same page and to ensure the production of a logical and informative article on Ulegyria.

Intoduction

Ulegyria is a condition of the cerebral cortex in which the gyri are distorted as a result of scarring and atrophy. The surface gyri are usually spared, while the deeper sulcal regions of the cortex are shrunken, giving a mushroom-like appearance of the gyri. This condition is often caused by hypoxic-ischemic brain injury during the perinatal stage of full-term infants. This gyral scarring is present throughout adulthood and can range in severity from asymptomatic to association with epilepsy, mental retardation, and cerebral palsy.

We will continue to improve this section as our project progresses.

History

We will describe how J Bresler first imaged and described these “mushroom-shaped” gyri in 1899.

Anatomy

The characteristic mushroom-like appearance is caused by gliosis and atrophy of the deeper regions of the cortex near the sulcus. However, the surface gyri usually maintain a normal appearance.

Ulegyria is found in either the posterior cerebral artery area or between the middle and posterior cerebral arteries. These regions are the most susceptible to hypoxic brain injuries.

We will continue to elaborate on the morphology of ulegyria as well as the portions of the brain most affected as well as add pictures and diagrams to better illustrate our points.

Causes

Ulegyria is caused by perinatal hypoxic-ischemic brain injury. This type of injury occurs shortly before, during, or after birth and refers to a severe lack of oxygen that causes damage to the cells in the central nervous. This injury can often lead to ulegyria because it results in atrophy and gliosis in the regions of the cortex near the deep folds of the sulcus.

We will discuss this injury further in our article.

Relation to other diseases

We will discuss how ulegyria is associated with other diseases including: epilepsy, mental retardation, and cerebral palsy.

We will also compare ulegyria with other types of similar cerebral scarring such as polymicrogyria.

Detection

Currently ulegyria is detected with MRI. The characteristics that are screened for are:

• lesions that are poorly defined
• “mushroom shaped” gyri that are characterized by a thinning of the cortex at the deep sulcal regions, while the crown of the cortex is spared
• white matter signal abnormalities on fluid- attenuated inversion-recovery (FLAIR) sequences

Screening for ulegyria is still difficult, especially because it closely resembles polymicrogyria on MRI scans. We will discuss studies that have tried to improve the ability to definitively identify ulegyria.

References

1. "Chapter three Perinatal Ischmia and Stroke." Perinatal Asphyxia. N.p., n.d. Web. 15 Sept. 2012.

2. Gil-Nagel A, García Morales I, Jiménez Huete A, Alvarez Linera J, del Barrio A, Ruiz Ocaña C, Muñoz DG. (2005) "Occipital lobe epilepsy secondary to ulegyria." J Neurol. 252(10):1178-85. PMID 15806340.

3. Hesham Montassir, Yoshihiro Maegaki, Kousaku Ohno, Kaeko Ogura. (2010.) "Long term prognosis of symptomatic occipital lobe epilepsy secondary to neonatal hypoglycemia." Epilepsy Research. 88(2-3): 93-99. ISSN 0920-1211.

4. Kim, H.-I., Lee, M.-C., Lee, J.-S., Kim, H.-S., Kim, M.-K., Woo, Y.-J., Kim, J.-H., Jung, S., Palmini, A. and Kim, S. U. (2006), Bilateral perisylvian ulegyria: Clinicopathological study of patients presenting with pseudobulbar palsy and epilepsy. Neuropathology, 26: 236–242. doi: 10.1111/j.1440-1789.2006.00659.x

5. Norman, Margaret G. (1981.) “On the morphogenesis of ulegyria.” Acta Neuropathologica. 53: 331-332. PMID 7223375.

6. Paramdeep Singh, Kavita Saggar, Parambir Sandhu, Munish Guleria. (2011.) "Ulegyria--The 'Mushroom' Gyri." JK Science. 13(1).

7. Urbach H. Imaging of the epilepsies. (2005) Eur Radiol. 15(3):494-500. PMID 15678321.

8. Usui, N., Mihara, T., Baba, K., Matsuda, K., Tottori, T., Umeoka, S., Nakamura, F., Terada, K., Usui, K. and Inoue, Y. (2008.) "Posterior cortex epilepsy secondary to ulegyria: Is it a surgically remediable syndrome?" Epilepsia. 49: 1998–2007. doi: 10.1111/j.1528-1167.2008.01697.x

9. Villani F, D'Incerti L, Granata T, Battaglia G, Vitali P, Chiapparini L, Avanzini G. (2003.) "Epileptic and imaging findings in perinatal hypoxic-ischemic encephalopathy with ulegyria." Epilepsy Res. 55(3): 235-43. PMID 12972177.