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Brain Tumors
Seizures may be the presenting sign of neonatal brain tumor. Seizures occur in about 14% to 20% of newborns with brain tumors. Brain tumors in neonates are more often supratentorial than infratentorial. Teratomas are the most frequent supratentorial tumors in neonates. They are usually present at the time of birth. Magnetic resonance imaging is the method of choice to diagnose brain tumors. Treatment is surgical. Chemotherapy is sometimes used. Radiotherapy is seldom used because of its deleterious effects on future neurological development. More about... 257, 288

Schizencephaly consists of a canal, surrounded by cerebral cortex, that allows communication between the subarachnoid space and the ventricles. Schizencephaly is diagnosed by CT or preferably by MRI. The MRI appearance of schizencephaly is very characteristic. It consists of a thin or wide canal that extends from the cerebral cortex to the ventricles. Schizencephaly is unilateral or bilateral. The walls of the clefts or lips exhibit abnormal cortex with frequent neuronal heterotropia. The lips may be adjacent or distant from each other. Schizencephaly occurs most often in the regions of the Rolandic and Sylvian fissures. Schizencephaly may be associated with optic nerve hypoplasia and absence of the septum pellucidum.
Neonates with closed-lip schizencephaly have a better prognosis than those with open-lip schizencephaly. Neonates with unilateral schizencephaly have a better prognosis than those with bilateral schizencephaly. Convulsions are treated with antiepileptic drugs. Hemiparesis and mental retardation may occur. Hemiparesis is seldom present in the neonatal period. The possibility of surgical treatment for medically uncontrollable epilepsy should be considered in neonates with schizencephaly. More about... 257


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Isaacs, 1997