Brain MRI Result and solution request

[Nejat]

I have a 16 months old daughter to whom I gave birth in C Section.  There were complications (Intrauterine cerebral ischemia, I believe is the medical words) and she used to take several medications including IV. She made a brain MRI and the diagnosis reads as follows:
"Protocol:
Axial T1, T2 & FLAIR; Sagittal T1&T2 and Coronal T2 scanning of the brain are performed without contrast media.

Findings:
Both lateral ventricles and third ventricle are grossly dilated with elevation and thinning of the corpus collasum.  There is also bilateral perisylvian abnormal development of frontal and temporal gyrus with widened sulci and loss of corticomedullary differentiation.

The basal ganglia and thalami are splayed by dilated ventricles otherwise the brain stem and cerebellar hemispheres are intact.  The fourth ventricle has normal size and shape.  The orbits, temporal region, Sella and perisellar regions are normal.  There are normal flow voids on both carotid and basilar arteries.  The visible Para nasal sinuses and mastoid air cells are clear.  Cranio vertebral junction is also normal."

She has not still crawled, talked, walked.  She has also gross esotropia and she doesn't seem to see from far and also with concentration.

I am worried about her and that if there is any solution for her, I want to try because I don't want to miss any opportunity she will have.  I also think that any treatment that will be available could be at an early age, which is her age now, and don't want to pass by the possible solution.  So please I need help! help! starting from what to do to the maximum solution.


I am afraid it might be related to autism!!!! Solution please!

[Esteban Cheng-Ching, MD]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.
Without the ability to examine your daughter and obtain a history, I can not comment on the cause of her problems. I will provide some information that I hope will be useful.
It seems that she has some developmental delay, as you say that she has not crawled, talked or walked. This is abnormal by itself and may or may not be related to the perinatal complications.
The report of the MRI that you provide also sounds abnormal. It is very difficult and almost impossible to interpret an MRI without the chance to look at it, and without being able to change the windows and sequences, however by the description, seems that her ventricles are enlarged, and there may be other cortical abnormalities. Unfortunately with this I cannot tell you if the MRI findings are the cause of her problems, and I cannot give you a diagnosis. The MRI is important in order to look at the brain structure, however many times other work up is needed in order to determine the exact cause of her problems. Certainly the perinatal complication may have played a role, however this does not rule out that other conditions may be affecting her and causing her developmental delay.
As you pointed out, it will be very important to find a diagnosis and a cause for her problems sooner rather than later, in order to start a potential therapy. Even starting physical and speech therapy sooner if required helps significantly.
Without a detailed history and physical exam, and without being able to look at the MRI myself, I cannot tell you what the cause of her problems is.
I think it is very important for you to take your daughter to a pediatric neurologist as soon as possible, and discuss the cause and her symptoms, as well as to outline a plan for further diagnostic work up if required, and treatment.
I hope this information is useful. Good luck.