Neuroimaging (MRI) in Children with Microcephaly and Severe Acute Malnutrition

• Author Details:   
• Neeraj Kumar
• Suresh Goyal
• Kavita Tiwari
• Vinita Goyal
• Pradeep Meena

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Objective: To study the change in brain by neuroimaging (MRI brain) in children with microcephaly and severe acute malnutrition aged 1 month to 60 months.
Materials and Methods: Children attending Bal Chikitsalaya, Maharana Bhupal Goverment Hospital, RNT Medical College, Udaipur (Rajasthan) were evaluated as per protocol. Microcephaly was defined as head circumference (HC) less than 3 SD or Z score <- 3. Nutrition status of microcephaly children was recorded using weight for height criteria. Change in brain was evaluated by neuroimaging (MRI).
Results: 65 children with microcephaly and SAM were enrolled in the study. 38(58.46%) were male and 27(41.54%) were female. Male to female ratio was 1.41:1. Most children presented with developmental delay 64(98.46%), abnormal tone 46(70.77%), convulsion 9(16.98%), regression of mile stone 5(7.69%) and tremor 5(7.69%). Anaemia was present in 62(95.38%) children. Among these children, TMBE 4(44.44%) was most common cause of convulsion followed by malaria 2(22.22%), hypocalcemia 2(22.22%) & pyogenic Meningitis 1(11.11%). The most frequent MRI findings were cerebral atropy in 42(64.62%) cases followed by finding of TBME with diffuse cerebral atropy in 5(7.69%), diffuse cerebral atropy with periventricular leucomalacia in 2(3.08%), diffuse cerebral atropy with delayed myelination in 1(1.54%), hypomyelination/ delayed myelination in 1(1.54%), leucomalacia with delayed myelination in 1(1.54%) and periventricular leucomalacia in 1(1.54%).
Conclusion: Most children with Microcephaly and SAM had developmental delay, anaemia, abnormal tone, regression of mile stone and convulsion. Cerebral atrophy was most frequent finding on neuroimaging (MRI).

Keywords: Cerebral atrophy, Developmental delay, Microcephaly, Neuroimaging, SAM