Microstructural white matter abnormalities in nodular heterotopia with overlying polymicrogyria.

Nodular heterotopia (NH) with overlying polymicrogyria can result in medically uncontrolled seizures. Most patients also exhibit deficits of function related to the location of the abnormal cortex. However, functional imaging studies show that the abnormal cortex can retain some function, making surgical planning difficult. It is not known if the connectivity of the abnormal cortex is normal. In this article, we performed an evaluation of molecular diffusion within the white matter in a patient with refractory epilepsy due to NH with overlying polymicrogyria. We observed that the white matter underlying the polymicrogyric area shows signs of microstructural abnormalities. This result suggests that the deficit of function from polymicrogyria result from both the structurally abnormal cortex and from its impaired connectivity.

Case of desmoplastic infantile ganglioglioma secreting ceruloplasmin.

Desmoplastic infantile ganglioglioma is a rare World Health Organization (WHO) grade I tumor commonly arising in early infancy and usually presenting with both solid and cystic components. We report a case of a large midline-enhancing desmoplastic infantile ganglioglioma in which newly formed cysts in communication with lateral ventricles contained highly proteinaceous fluid. Proteomic analysis of the fluid showed three proteins not normally found in cerebrospinal fluid. Immunohistochemical analysis of the tumor sample showed that the desmoplastic infantile ganglioglioma produced a high concentration of ceruloplasmin, which probably accounts for most of the 30- to 40-fold increase in protein compared with normal cerebrospinal fluid. To our knowledge, this is the first report of ceruloplasmin secretion by a brain tumor, and ongoing studies on the mechanism might yield novel approaches to reducing cyst production and protein content in an otherwise stable solid tumor.