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Journal of Pediatric Neurology 2024; 22(02): 158-165
DOI: 10.1055/s-0044-1786783
Review Article

Malformations of the Cerebral Commissures

Germana Lena‡   *
1   Pediatrics Postgraduate Residency Program, University of Catania, Catania, Italy
,
Daria La Cognata‡   *
1   Pediatrics Postgraduate Residency Program, University of Catania, Catania, Italy
,
Antonio Zanghì‡   *
2   Department of Medical and Surgical Sciences and Advanced Technologies, Research Center for Surgery of Complex Malformation Syndromes of Transition and Adulthood, University of Catania, Catania, Italy
,
Michele Vecchio
3   Department of Biomedical and Biotechnological Sciences, Rehabilitation Unit, University of Catania, Catania, Italy
,
Rita Chiaramonte
3   Department of Biomedical and Biotechnological Sciences, Rehabilitation Unit, University of Catania, Catania, Italy
,
Raffaele Falsaperla
4   Neonatal Intensive Care Unit and Neonatology, University Hospital “Policlinico Rodolico-San Marco”, Catania, Italy
,
Francesco Marino
5   Department of Medical Surgical Sciences and Advanced Technologies, University Hospital Policlinico “G. Rodolico-San Marco”, Catania, Italy
,
Stefano Palmucci
6   Department of Medical Surgical Sciences and Advanced Technologies, IPTRA Unit, University Hospital Policlinico “G. Rodolico-San Marco”, Catania, Italy
,
Giuseppe Belfiore
7   Department of Medical Surgical Sciences and Advanced Technologies, Unit of Radiology 1, University Hospital Policlinico “G. Rodolico-San Marco”, Catania, Italy
,
Antonio Basile
7   Department of Medical Surgical Sciences and Advanced Technologies, Unit of Radiology 1, University Hospital Policlinico “G. Rodolico-San Marco”, Catania, Italy
,
Andrea D. Praticò
8   Chair of Pediatrics, Department of Medicine and Surgery, Kore University, Enna, Italy
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Abstract

Malformations of the cerebral commissures are abnormalities involving the structures which connect the brain hemispheres. The main cerebral commissures are the anterior commissure, the hippocampal commissure, and the corpus callosum, which is the largest and best known of the three and connects the neocortex of the two cerebral hemispheres. Commissures of more reduced extension are the posterior commissure and the habenular commissure. They derive embryologically from the same structure, the commensurate plate. Any interference in the embryological development of the brain commissures may cause an anomaly of all the three commissures or of a single commissure, as well as any combination of anomalies of each of them.

Each of these three commissural traits may be absent, isolated, or in combination. The abnormality of the commissures, in addition, can be complete or partial, with dysplasia of the meninges, with multicystic dysplasia of the interhemispheric meninges, in the context of Aicardi syndrome or with the presence of interhemispheric lipomas.

The complete agenesis of the commissures (“classic” form) is the most common form and encompasses more than a third of the cases. In complete agenesis, by definition, both the corpus callosum and the hippocampal commissure are totally absent.

Anomalies of the commissural structures associated with dysplasia of the meninges include the agenesis of the corpus callosum with interhemispheric cysts (a complex spectrum of clinical and neuroradiological conditions characterized by the associated presence of an interhemispheric cyst formed by communicating cavities) and the agenesis of commissures with interhemispheric lipomas that are usually located in the subarachnoid space.

Genes responsible for axonal migration to the commissural plate and those responsible for crossing and connections with the neurons of the contralateral hemisphere are multiple, so that malformations of the cerebral commissure/corpus callosum can be found in numerous malformative syndromes with other multiple associated abnormalities.

Keywords

cerebral commissures - corpus callosum - genetics - child neurology

* These authors contributed equally to this article.




Publication History

Received: 27 November 2023

Accepted: 04 April 2024

Article published online:
11 May 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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