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Diffuse Cerebral Atrophy
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Diffuse Cerebral Atrophy

My 17 month old daughter recently saw a pediatric neurologist.  After reviewing a CT scan that was taken on my daughter's head at 6 months of age, he indicated that she has benign enlargement of the subarachnoid spaces.  This he noted, has resulted in macrocephy and gross motor delays (which she has).

My daughter also has a condition called benign paroxysmal torticollis.  It appears that she suffers from headaches (sometimes with vomiting) and it is my understanding that this condition is a migrane (migraine) variant. She works with an occupational therapist monthly and was in physiotherapy until 11 months of age.  This is definately helping.

The report that came with the CT scan indicated there was diffuse cerebral atrophy.  What is this?  The neurologist said that he would not associate this with a child with macrocephy, etc.  The CT scan was done at our local hospital when my daughter had a fever and bulging fontanelle (no cause was ever attributed to this - blood culture, lumbar puncture, etc all clear).  Could the radiologist reviewing the scan has mistaken the benign enlargement of the subarachnoid spaces with diffuse cerebral atrophy?  No one ever mentioned the diffuse cerebral atrophy to me.  When I try to look it up on the internet, there are many references to Alzheimer's (which my mother-in-law died from at an early age).

Do I need to worry about this or ask for any further investigations to be done?  The neurologist did not seem concerned but I am puzzled with the diagnosis of diffuse cerebral atrophy.  We live in Canada, so any further tests would be months away.

Any insight you can provide would be greatly appreciated.
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Dear WendyB:

I am sorry to hear about your daughter, but it does sound like your doing all the correct things for her.  Does she have other delays, inaddition to gross motor?  I would suggest an MRI of the brain.  Now that she is older, it will give the pediatric neurologist a better look into the possibilities of diffuse cortical atrophy, if it indeed real, and if there might be other things going on.  One can see diffuse cortical atrophy by noting the size of the ventricles.  If they are large or age, then this might be an indication of atrophy. The subarchnoid or subdural space is outside the brain and the ventricles lie inside the brain so one would not be mistaken for the other.   One can see this on the CT, but an MRI will give a better view of the miyelination pattern and the amount of myelination.  I feel that one need to know what might be the cause and then if possible do what we can to correct the problem.

Sincerely,

CCF Neuro MD
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A related discussion, brain atrophy was started.
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A related discussion, diffused cerebral atrophy with ischemic degeneration was started.
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