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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2019; 77(04): 292-293
DOI: 10.1590/0004-282X20190029
Images in Neurology

A complex association of cardiomyopathy, mild dysmorphisms and leukoencephalopathy

Uma associação complexa de cardiomiopatia, dismorfismos discretos e leucoencefalopatia
Paulo Victor Sgobbi de Souza
1   Universidade Federal de São Paulo, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brasil.
,
Luiz Henrique Libardi Silva
1   Universidade Federal de São Paulo, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brasil.
,
Bruno de Mattos Lombardi Badia
1   Universidade Federal de São Paulo, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brasil.
,
Igor Braga Farias
1   Universidade Federal de São Paulo, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brasil.
,
Wladimir Bocca Vieira de Rezende Pinto 
1   Universidade Federal de São Paulo, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brasil.
,
Acary Souza Bulle Oliveira
1   Universidade Federal de São Paulo, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brasil.
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A 44-year-old woman presented with a 15-year history of ataxic gait. Medical history disclosed global developmental delay and supravalvular aortic stenosis and persistent arterial duct. Examination showed facial dysmorphisms (dysmorphic ears, broad nose, ocular hypertelorism), dysbasia and bilateral dysmetria. Neuroimaging studies disclosed diffuse leukoencephalopathy ([Figures 1] and [2]). Whole-exome sequencing was unremarkable. Microarray-based Comparative Genomic Hybridization disclosed 9p24.3 duplication, diagnosing partial trisomy 9p syndrome.

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Figure 1 Neuroimaging findings in partial trisomy 9p syndrome. Sagittal (A), axial (B) and coronal (C) brain MRI disclosing thin corpus callosum and diffuse hyperintensity of periventricular, deep and subcortical cerebral and cerebellar white matter in T2-weighted sequences with corresponding hypointensity in T1-weighted sequence (D).
Zoom Image
Figure 2 (A-D) Axial brain MRI showing marked white matter involvement in cerebellar, superior cerebellar peduncle and anterior temporal pole, and diffuse hyperintensity of periventricular, deep and subcortical cerebral white matter in FLAIR sequences.

Partial trisomy 9p syndrome is a common chromosomal disorder associated with facial and appendicular dysmorphisms, congenital cardiopathy, cognitive and motor compromise[1],[2], and different patterns of neuroimaging disturbances, including neuronal migration disorders, Dandy-Walker malformation[1],[2] and leukoencephalopathy, as presented here.


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Conflict of interest:

There is no conflict of interest to declare.

  • References

  • 1 Guilherme RS, Meloni VA, Perez AB, Pilla AL, Ramos MA, Dantas AG, et al. Duplication 9p and their implication to phenotype. BMC Med Genet 2014 Dec;15:142. https://doi.org/10.1186/s12881-014-0142-1
  • 2 Federico A, Tomasetti P, Zollino M, Diomedi M, Dotti MT, De Stefano N, et al. Association of trisomy 9p and band heterotopia. Neurology 1999;53(2):430-2.

Address for correspondence

Wladimir Bocca Vieira de Rezende Pinto
Departamento de Neurologia e Neurocirurgia da UNIFESP; Rua Estado de Israel, 899; 04022-002 São Paulo SP
Brasil   

Publication History

Received: 15 December 2018

Accepted: 15 January 2019

Article published online:
16 August 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Guilherme RS, Meloni VA, Perez AB, Pilla AL, Ramos MA, Dantas AG, et al. Duplication 9p and their implication to phenotype. BMC Med Genet 2014 Dec;15:142. https://doi.org/10.1186/s12881-014-0142-1
  • 2 Federico A, Tomasetti P, Zollino M, Diomedi M, Dotti MT, De Stefano N, et al. Association of trisomy 9p and band heterotopia. Neurology 1999;53(2):430-2.

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Zoom Image
Figure 1 Neuroimaging findings in partial trisomy 9p syndrome. Sagittal (A), axial (B) and coronal (C) brain MRI disclosing thin corpus callosum and diffuse hyperintensity of periventricular, deep and subcortical cerebral and cerebellar white matter in T2-weighted sequences with corresponding hypointensity in T1-weighted sequence (D).
Zoom Image
Figure 2 (A-D) Axial brain MRI showing marked white matter involvement in cerebellar, superior cerebellar peduncle and anterior temporal pole, and diffuse hyperintensity of periventricular, deep and subcortical cerebral white matter in FLAIR sequences.