Clinical and pathological characteristics and surgical efficacy of early brain injury with focal cortical dysplasia IIId in children

Yan LI; Yunlin LI; Yongling LIU; Jing FU

ABSTRACT

Objective:

To investigate the clinical and pathological characteristics and surgical efficacy of early brain injury with focal cortical dysplasia (FCD) IIId in children.

Methods:

Forty-nine children with epilepsy accepted surgical treatment in our hospital from January 2008 to July 2017 were chosen in our study; these patients were pathologically diagnosed as having FCD IIId. These children were divided into 7 groups according to different brain injuries cerebral hemorrhage ( n=13), central nervous system infectious disease ( n=19), cerebral infarction ( n=1), intrapartum hypoxia ( n=5), two kinds of early brain injury ( n=2), febrile seizure ( n=6), traumatic brain injury ( n=3). Two years after surgery, Engel grading was used to evaluate the surgical efficacy of the children. The clinical and pathological characteristics of these children were retrospectively analyzed.

Results:

The average age of brain injury was 0 d-3.8 years, the average age of epilepsy was 4-5.3 years, and the average age of surgery was 7-10.2 years. The incidence of multiple lobe brain injury in the cerebral hemorrhage group (100%, 13/13) was significantly higher than that in the central nervous system infectious diseases group (36.8%, 7/19,) and febrile seizure group (50%, 3/6, P<0.05). There was a significant difference in Engel grading I ratio between cerebral hemorrhage group (84.6%, 11/13) and central nervous system infectious disease group (42.1%, 8/19, P<0.05); Engel grading I and II was noted in 80.0% children (4/5) of the intrapartum hypoxia group. All children had pathological changes and pathological characteristics of FCD after early brain injury.

Conclusion:

FCD IIId children with cerebral hemorrhage or intrapartum hypoxia have good surgical effect, which may be related to the early occurrence of early brain damage, clear pathological changes, and clear boundary between the focus and the surrounding brain tissues.